Paravalvular leak closure under intracardiac echocardiographic guidance
<h4>Objectives</h4> <p>The objective of this study was to determine the safety and efficacy of intracardiac echocardiography (ICE) to guide percutaneous paravalvular leak (PVL) closure.</p> <h4>Background</h4> <p>PVL following surgical valve replacement occ...
| Autori principali: | , , , , , |
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| Natura: | Journal article |
| Lingua: | English |
| Pubblicazione: |
Wiley
2017
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| _version_ | 1826294818468265984 |
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| author | Ruparelia, N Cao, J Newton, J Wilson, N Daniels, M Ormerod, O |
| author_facet | Ruparelia, N Cao, J Newton, J Wilson, N Daniels, M Ormerod, O |
| author_sort | Ruparelia, N |
| collection | OXFORD |
| description | <h4>Objectives</h4> <p>The objective of this study was to determine the safety and efficacy of intracardiac echocardiography (ICE) to guide percutaneous paravalvular leak (PVL) closure.</p> <h4>Background</h4> <p>PVL following surgical valve replacement occurs in 2%–15% of patients. Percutaneous treatment is an accepted management strategy in patients deemed to be too high risk for redo surgery. This is most commonly performed with transesophageal (TOE) guidance requiring general anesthesia that both potentially further increase the risk of intervention. ICE can be used to guide intervention, facilitating procedures to be performed under local anesthesia without esophageal intubation potentially making procedures shorter and safer and further enabling the treatment of patients that may have been turned down for intervention.</p> <h4>Methods</h4> <p>All patients that underwent ICE-guided percutaneous transcatheter PVL closure between 2006 and 2016 at the John Radcliffe Hospital, Oxford, United Kingdom were retrospectively analyzed.</p> <h4>Results</h4> <p>Twenty-one procedures were performed in 18 patients during the study period. Fourteen patients (77.8%) underwent successful ICE guided PVL closure. There were no ICE-related complications. Eleven patients (78.6%) reported symptomatic improvement of at least one New York Heart Association (NYHA) Class and the remaining 3 patients had no change. No patient demonstrated objective evidence of persistent hemolysis following successful closure. There was one death within 30 days of the procedure and 1 year survival was 71.4%.</p> <h4>Conclusions</h4> <p>Percutaneous paravalvular leak closure guided by ICE without the requirement of general anesthesia is feasible, safe, and associated with acceptable procedural success rates.</p> |
| first_indexed | 2024-03-07T03:51:32Z |
| format | Journal article |
| id | oxford-uuid:c1719e34-6d7a-44be-94db-7f4660c4c238 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:51:32Z |
| publishDate | 2017 |
| publisher | Wiley |
| record_format | dspace |
| spelling | oxford-uuid:c1719e34-6d7a-44be-94db-7f4660c4c2382022-03-27T06:01:27ZParavalvular leak closure under intracardiac echocardiographic guidanceJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c1719e34-6d7a-44be-94db-7f4660c4c238EnglishSymplectic Elements at OxfordWiley2017Ruparelia, NCao, JNewton, JWilson, NDaniels, MOrmerod, O <h4>Objectives</h4> <p>The objective of this study was to determine the safety and efficacy of intracardiac echocardiography (ICE) to guide percutaneous paravalvular leak (PVL) closure.</p> <h4>Background</h4> <p>PVL following surgical valve replacement occurs in 2%–15% of patients. Percutaneous treatment is an accepted management strategy in patients deemed to be too high risk for redo surgery. This is most commonly performed with transesophageal (TOE) guidance requiring general anesthesia that both potentially further increase the risk of intervention. ICE can be used to guide intervention, facilitating procedures to be performed under local anesthesia without esophageal intubation potentially making procedures shorter and safer and further enabling the treatment of patients that may have been turned down for intervention.</p> <h4>Methods</h4> <p>All patients that underwent ICE-guided percutaneous transcatheter PVL closure between 2006 and 2016 at the John Radcliffe Hospital, Oxford, United Kingdom were retrospectively analyzed.</p> <h4>Results</h4> <p>Twenty-one procedures were performed in 18 patients during the study period. Fourteen patients (77.8%) underwent successful ICE guided PVL closure. There were no ICE-related complications. Eleven patients (78.6%) reported symptomatic improvement of at least one New York Heart Association (NYHA) Class and the remaining 3 patients had no change. No patient demonstrated objective evidence of persistent hemolysis following successful closure. There was one death within 30 days of the procedure and 1 year survival was 71.4%.</p> <h4>Conclusions</h4> <p>Percutaneous paravalvular leak closure guided by ICE without the requirement of general anesthesia is feasible, safe, and associated with acceptable procedural success rates.</p> |
| spellingShingle | Ruparelia, N Cao, J Newton, J Wilson, N Daniels, M Ormerod, O Paravalvular leak closure under intracardiac echocardiographic guidance |
| title | Paravalvular leak closure under intracardiac echocardiographic guidance |
| title_full | Paravalvular leak closure under intracardiac echocardiographic guidance |
| title_fullStr | Paravalvular leak closure under intracardiac echocardiographic guidance |
| title_full_unstemmed | Paravalvular leak closure under intracardiac echocardiographic guidance |
| title_short | Paravalvular leak closure under intracardiac echocardiographic guidance |
| title_sort | paravalvular leak closure under intracardiac echocardiographic guidance |
| work_keys_str_mv | AT ruparelian paravalvularleakclosureunderintracardiacechocardiographicguidance AT caoj paravalvularleakclosureunderintracardiacechocardiographicguidance AT newtonj paravalvularleakclosureunderintracardiacechocardiographicguidance AT wilsonn paravalvularleakclosureunderintracardiacechocardiographicguidance AT danielsm paravalvularleakclosureunderintracardiacechocardiographicguidance AT ormerodo paravalvularleakclosureunderintracardiacechocardiographicguidance |