Paravalvular Regurgitation: Clinical Outcomes in Surgical and Percutaneous Treatments

Arquivos Brasileiros de Cardiologia. 2016;(0) DOI 10.5935/abc.20160086

 

Journal Homepage

Journal Title: Arquivos Brasileiros de Cardiologia

ISSN: 0066-782X (Print); 1678-4170 (Online)

Publisher: Sociedade Brasileira de Cardiologia (SBC)

Society/Institution: Sociedade Brasileira de Cardiologia

LCC Subject Category: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system

Country of publisher: Brazil

Language of fulltext: Portuguese, English

Full-text formats available: PDF, HTML, XML

 

AUTHORS

Carlos Passos Pinheiro
Daniele Rezek
Eduardo Paiva Costa
Edvagner Sergio Leite de Carvalho
Freddy Antonio Brito Moscoso
Percy Richard Chavez Taborga
Andreia Dias Jeronimo
Alexandre Antonio Cunha Abizaid
Auristela Isabel de Oliveira Ramos

EDITORIAL INFORMATION

Peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 10 weeks

 

Abstract | Full Text

Abstract Background: Paravalvular regurgitation (paravalvular leak) is a serious and rare complication associated with valve replacement surgery. Studies have shown a 3% to 6% incidence of paravalvular regurgitation with hemodynamic repercussion. Few studies have compared surgical and percutaneous approaches for repair. Objectives: To compare the surgical and percutaneous approaches for paravalvular regurgitation repair regarding clinical outcomes during hospitalization and one year after the procedure. Methods: This is a retrospective, descriptive and observational study that included 35 patients with paravalvular leak, requiring repair, and followed up at the Dante Pazzanese Institute of Cardiology between January 2011 and December 2013. Patients were divided into groups according to the established treatment and followed up for 1 year after the procedure. Results: The group submitted to percutaneous treatment was considered to be at higher risk for complications because of the older age of patients, higher prevalence of diabetes, greater number of previous valve surgeries and lower mean creatinine clearance value. During hospitalization, both groups had a large number of complications (74.3% of cases), with no statistical difference in the analyzed outcomes. After 1 year, the percutaneous group had a greater number of re-interventions (8.7% vs 20%, p = 0.57) and a higher mortality rate (0% vs. 20%, p = 0.08). A high incidence of residual mitral leak was observed after the percutaneous procedure (8.7% vs. 50%, p = 0.08). Conclusion: Surgery is the treatment of choice for paravalvular regurgitation. The percutaneous approach can be an alternative for patients at high surgical risk.