• Abhijeet Dhoble, Tarun Chakravarty, Mamoo Nakamura, Yigal Abramowitz, Rikin Tank, Hirotsugu Mihara, Geeteshwar Mangat, Hasan Jilaihawi, Takahiro Shiota, and Raj Makkar.
• Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, 127 S. San Vicente Blvd, Suite A 3600, Los Angeles, California, 90048.
• Catheter Cardiovasc Interv. 2017 Feb 15; 89 (3): 462-468.

BackgroundSignificant paravalvular leak (PVL) occurs in up to 13% of patients after transcatheter aortic valve replacement (TAVR) with a balloon-expandable bioprosthesis. Transcatheter PVL repair has emerged as a less invasive alternative for this problem.ObjectivesThe aim of this study was to evaluate the safety, feasibility, and clinical outcomes of transcatheter PVL repair after TAVR with balloon-expandable valve.MethodsWe retrospectively identified 15 patients who underwent 16 PVL repair procedures after the TAVR at our center. Procedural characteristics, results, and clinical outcomes were analyzed. The association of PVL repairs with subsequent hospitalizations and mortality was assessed and compared to 57 patients who did not undergo repair for at least moderate PVL after TAVR.ResultsThe PVL repair was successful in 13 (87%) patients, without significant procedure or device related complications. In patients with successful PVL repair, there was an improvement in symptom status, subsequent hospitalizations, and B-type natriuretic peptide levels. There was 1 (out of 13, 8%) death in the group of patients who successfully underwent PVL repair whereas 24 (out of 57, 42%) patients died during follow up in the group that did not undergo repair of their PVL. Similarly, there was significant reduction in the subsequent heart failure related hospitalization after the PVL repair, compared with the patients who did not undergo PVL repair (P = 0.03).ConclusionTranscatheter repair of PVL after TAVR can be safely and effectively accomplished in carefully selected patients, and may lead to reduction in hospitalizations, improvement in symptoms, and long-term survival. © 2016 Wiley Periodicals, Inc.© 2016 Wiley Periodicals, Inc.

42 keywords...

hide…