Comparison of transcatheter and surgical treatment of paravalvular leak : Results from a 5‐year follow‐up study
Abstract Objective This study aimed to compare the efficacy and safety of two different treatments of paravalvular leak (PVL). Background PVL is a common complication after surgical valve replacement. Re‐operation is associated with high mortality, morbidity, and risk of re‐leak. Catheter‐based repair has emerged as a promising new therapy. Methods and Results Eighty‐seven consecutive patients with symptomatic PVL received either transcatheter ( n = 46) or surgical ( n = 41) treatment at Shanghai Chest Hospital between January 2009 and December 2015.The procedural and clinical success rates were similar between the transcatheter group and the surgical group (82.6 vs. 90.2%; P = 0.30; and 69.5 vs. 73.0%; P = 0.71, respectively). There were fewer in‐hospital total major adverse events in the transcatheter group (56.09 vs. 17.39%; P < 0.001), and transcatheter repair was more cost‐effective, with fewer blood transfusions, shorter procedure durations, shorter hospital stays, and less expenditure. However, there were six cases of hemolysis aggravation in the transcatheter group (13.04%). The 5‐year overall survival rates after transcatheter and surgical repair were 74.39 and 71.95% ( P = 0.45), respectively, and the cardiac‐related survival rates were 84.08 and 74.72% ( P = 0.19), respectively. Conclusion Transcatheter and surgical repairs are both effective treatments for selected patients with PVL. And, transcatheter closure seems to be safer and more cost‐effective. Nonetheless, this new treatment may be risky for post‐procedure hemolysis when unsuitable devices are used..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:94 |
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| Enthalten in: |
Catheterization and Cardiovascular Interventions - 94(2019), 2, Seite E88-E95 |
| Beteiligte Personen: |
Zhang, Youjun [VerfasserIn] |
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| BKL: |
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| Anmerkungen: |
© 2019 Wiley Periodicals, Inc. |
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| Umfang: |
8 |
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| doi: |
10.1002/ccd.27371 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Abstract Objective This study aimed to compare the efficacy and safety of two different treatments of paravalvular leak (PVL). Background PVL is a common complication after surgical valve replacement. Re‐operation is associated with high mortality, morbidity, and risk of re‐leak. Catheter‐based repair has emerged as a promising new therapy. Methods and Results Eighty‐seven consecutive patients with symptomatic PVL received either transcatheter ( n = 46) or surgical ( n = 41) treatment at Shanghai Chest Hospital between January 2009 and December 2015.The procedural and clinical success rates were similar between the transcatheter group and the surgical group (82.6 vs. 90.2%; P = 0.30; and 69.5 vs. 73.0%; P = 0.71, respectively). There were fewer in‐hospital total major adverse events in the transcatheter group (56.09 vs. 17.39%; P < 0.001), and transcatheter repair was more cost‐effective, with fewer blood transfusions, shorter procedure durations, shorter hospital stays, and less expenditure. However, there were six cases of hemolysis aggravation in the transcatheter group (13.04%). The 5‐year overall survival rates after transcatheter and surgical repair were 74.39 and 71.95% ( P = 0.45), respectively, and the cardiac‐related survival rates were 84.08 and 74.72% ( P = 0.19), respectively. Conclusion Transcatheter and surgical repairs are both effective treatments for selected patients with PVL. And, transcatheter closure seems to be safer and more cost‐effective. Nonetheless, this new treatment may be risky for post‐procedure hemolysis when unsuitable devices are used. | ||
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