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使用特定用途装置经心尖导管封堵二尖瓣瓣周漏的单中心早期和中期结果的回顾性分析。

Retrospective analysis of single-center early and midterm results of transapical catheter-based mitral paravalvular leak closure with a purpose-specific device.

作者信息

Zorinas Aleksejus, Janušauskas Vilius, Davidavičius Giedrius, Šimakauskas Rokas, Puodžiukaitė Lina, Zakarkaitė Diana, Bilkis Valdas, Čypienė Rasa Joana, Samalavičius Robertas Stasys, Onorato Eustaquio M, Aidietis Audrius, Ručinskas Kęstutis

机构信息

Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Department of Pathology, Forensic Medicine and Pharmacology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

Postepy Kardiol Interwencyjnej. 2018;14(2):167-175. doi: 10.5114/aic.2018.76408. Epub 2018 Jun 19.

Abstract

INTRODUCTION

Due to the recent lack of definitions to establish the severity of paravalvular leak (PVL) and endpoints for its treatment, the effectiveness and safety of a new device for PVL closure have not been comprehensively analyzed.

AIM

To analyze a single center's experience of mitral PVL closure in a surgical transapical catheter-based fashion with a purpose-specific device.

MATERIAL AND METHODS

This is a retrospective cohort study of patients following transapical catheter-based mitral PVL closure with a purpose-specific device. Data were analyzed at baseline, perioperatively, at discharge, at six months and annually after the procedure.

RESULTS

Nineteen patients underwent surgical transapical catheter-based mitral PVL closure with the Occlutech PLD Occluder. Mean follow-up time was 20 ±7 (range: 9-33) months. The patients' mean age was 64 ±7 years, and 11 (58%) were male. Technical, device and individual patient success at follow-up was achieved in 18 (95%), 16 (84%) and 16 (84%) patients respectively. Median intensive therapy unit stay was one day (1-4) and mean hospital stay was 11 ±4 days. A reduction of paravalvular regurgitation to a mild or lesser degree was achieved in 18 (95%) patients. There were no strokes or myocardial infarctions at follow-up. There were no deaths at 30 days after the procedure. One (5%) patient expired due to progression of heart failure 12 months after surgery. None of the patients required immediate conversion to full sternotomy.

CONCLUSIONS

Surgical transapical catheter-based mitral PVL closure with the Occlutech PLD Occluder is a safe and clinically effective treatment.

摘要

引言

由于近期缺乏用于确定瓣周漏(PVL)严重程度的定义及其治疗终点,一种用于PVL封堵的新装置的有效性和安全性尚未得到全面分析。

目的

分析单中心采用特定用途装置经心尖导管技术进行二尖瓣PVL封堵的经验。

材料与方法

这是一项对采用特定用途装置经心尖导管技术进行二尖瓣PVL封堵患者的回顾性队列研究。在基线、围手术期、出院时、术后6个月及每年对数据进行分析。

结果

19例患者采用Occlutech PLD封堵器经心尖导管技术进行二尖瓣PVL封堵。平均随访时间为20±7(范围:9 - 33)个月。患者平均年龄为64±7岁,11例(58%)为男性。随访时技术成功率、装置成功率和个体患者成功率分别为18例(95%)、16例(84%)和16例(84%)。重症监护病房中位住院时间为1天(1 - 4天),平均住院时间为11±4天。18例(95%)患者的瓣周反流减轻至轻度或更低程度。随访期间无卒中或心肌梗死发生。术后30天无死亡病例。1例(5%)患者在术后12个月因心力衰竭进展死亡。所有患者均无需立即转为正中开胸手术。

结论

采用Occlutech PLD封堵器经心尖导管技术进行二尖瓣PVL封堵是一种安全且临床有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8586/6041841/6697c3167cb3/PWKI-14-33024-g001.jpg

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