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Catheter-based mitral valve paravalvular leak closure. Early results.
Aleksejus Zorinas, Valdas Bilkis, Rokas Simakauskas, Vilius Janusauskas, Kestutis Rucinskas, Giedrius Davidavicius, Diana Zakarkaite, Audrius Aidietis.
Vilnius University, Vilnius, Lithuania.

OBJECTIVE: After mitral valve replacement paravalvular leak may occur in up to 17% of patients. Patients with paravalvular leak present with symptoms of heart failure and/or anemia. Surgical closure is associated with increased morbidity and mortality. Alternative transcatheter closure has been developed and introduced into the clinical practice with a reasonable success. To the date more evidence is needed to compare the efficacy and safety of catheter-based paravalvular mitral valve leak closure.
Our objective is to present early results of efficacy and safety of catheter-based paravalvular mitral valve leak closure.
METHODS: A retrospective analysis of patients' medical records treated for mitral paravalvular leak at our institution in year 2005-2015. 10 patients had catheter-based procedure (trans apical approach). Patients' data, operative variables, postoperative complications, 1 and 4 months postoperative results were analyzed.
RESULTS: Patients in our analysed group were 71 ± 6 years old and had incidence of essential hypertension 80%. The average length of the procedure to close paravalvular leak was 86 min. Early after the treatment mild/moderate regurgitation of a paravalvular leak was found more frequently in 50% of the patients.
CONCLUSIONS: Catheter-based closure of a paravalvular leak is reserved for older patients. The procedure of catheter-based paravalvular leak closure is quick, patients have high incidence of mild/moderate paravalvular leak after the procedure. With more clinical experience and development of special equipment, catheter-based paravalvular leak closure could be a possible alternative to the conventional operation.


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