Li Yue, Jin Ping, Guo Hong, Mao Yu, Liu Yang, Zhai Mengen, Yang Jian
Department of Cardio-Vascular Surgery, Air Force Medical Center of People's Liberation Army, Beijing, China.
Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China.
Catheter Cardiovasc Interv. 2024 Dec;104(7):1499-1507. doi: 10.1002/ccd.31135. Epub 2024 Jul 31.
Paravalvular leakage (PVL) is a common complication after artificial valve replacement. Transcatheter paravalvular leak closure (PVT), an efficient, safe, and minimally invasive treatment for PVL patients.
The purpose of this study was to present our experience with transcatheter closure of mitral paravalvular leakage (PVL) after surgical valve replacement in our center.
A cohort of 81 consecutive patients with mitral PVLs was treated with transcatheter closure between September 2014 and December 2022. We reviewed the demographics, clinical features, therapeutic modalities and follow-up results. The patients' charts were used for retrospective analysis.
Eighty-one patients from one center were enrolled in this study. The median age of the patients was 63 ± 11 years. The median LVEF was 51% ± 7%, and the median regurgitation volume was 11.5 ± 10.1 mL. Sealing with occlusion was successful in 70 patients, and the technical success rate was 86.5%. The median regurgitation volume was reduced to 1.95 ± 2.6 mL. The major adverse event was hemolysis, which affected 19 patients, 17 of whom required blood transfusion. Three patients required secondary open surgery due to bleeding. Three patients died during the hospital stay, and all of their deaths were caused by hemolysis-related complications. The median hospital stay was 10.3 ± 6.3 days. During the follow-up period, 2 patients died, and none of their deaths were caused by surgery. The New York Heart Association classification increased in all patients during the 6-month follow-up.
Transcatheter mitral PVL closure requires complex catheter techniques. However, this technique is minimally invasive and has a shorter hospital stay. Interventional mitral PVL closure is a safe and efficacious technique for high-risk surgical patients with symptomatic paravalvular regurgitation.
瓣周漏（PVL）是人工瓣膜置换术后的常见并发症。经导管瓣周漏封堵术（PVT）是一种针对PVL患者的高效、安全且微创的治疗方法。
本研究旨在介绍我们中心在外科瓣膜置换术后经导管封堵二尖瓣瓣周漏（PVL）的经验。
2014年9月至2022年12月期间，对连续81例二尖瓣PVL患者进行了经导管封堵治疗。我们回顾了患者的人口统计学资料、临床特征、治疗方式及随访结果。使用患者病历进行回顾性分析。
本研究纳入了来自一个中心的81例患者。患者的中位年龄为63±11岁。左心室射血分数（LVEF）中位数为51%±7%，反流容积中位数为11.5±10.1mL。70例患者封堵成功，技术成功率为86.5%。反流容积中位数降至1.95±2.6mL。主要不良事件为溶血，19例患者受影响，其中17例需要输血。3例患者因出血需要二次开胸手术。3例患者在住院期间死亡，均死于溶血相关并发症。中位住院时间为10.3±6.3天。随访期间，2例患者死亡，均非手术所致。在6个月的随访期间，所有患者的纽约心脏协会分级均有所改善。
经导管二尖瓣PVL封堵术需要复杂的导管技术。然而，该技术具有微创性且住院时间较短。对于有症状的瓣周反流的高危手术患者，介入性二尖瓣PVL封堵术是一种安全有效的技术。
