Closure of Three Separate Complex Paravalvular Defects with Four Devices By Transapical Approach

Yıl 2020, Cilt: 23 Sayı: 2, 148 - 152, 16.08.2020

Alev Kılıçgedik Deniz Çevirme Mehmet Türkmen Cevat Kırma Mehmet Özkan

Öz

Paravalvular leaks (PVL) that complicate prosthetic valve replacement may be observed in 2%-12% of the patients after mitral valve replacement and 1%-5% of the patients after aortic valve replacement. The percutaneous closure of PVL is considered as a less invasive alternative to a surgical closure for symptomatic relief in high-risk patients. The objective of this case report is to present a successful transapical closure of three separate mitral paravalvular defects with four devices in a patient with severe hemolysis.

Anahtar Kelimeler

Paravalvular leak, echocardiography, leak

Üç Ayrı Paravalvüler Defektin Transapikal Yol ile Dört Ayrı Cihazla Kapatılması

Öz

Protez kapak yerleştirilmesi operasyonlarının bir komplikasyonu olarak paravalvüler kaçaklar (PVL) mitral protez kapak yerleştirilmesi sonrası %2-12 ve aortik protez kapak yerleştirilmesi sonrası %1-5 oranında görülebilir. Semptomatik yüksek riskli hastalarda, perkütan PVL kapatma işlemi cerrahiye göre daha az invaziv bir alternatiftir. Bu olgu bildirisinde, ciddi hemolizi olan semptomatik bir hastada üç ayrı mitral paravalvüler defektin dört cihaz ile transapikal başarılı olarak kapatılması sunulmuştur.

Anahtar Kelimeler

Paravalvüler yetersizlik, ekokardiyografi

Kaynakça

• 1. leak closure. Curr Treat Options Cardiovasc Med 2013;15:565-74.
• 2. Kim MS, Casserly IP, Garcia JA, Klein AJ, Salcedo EE, Carroll JD. Percutaneous transcatheter closure of prosthetic mitral paravalvular leaks: are we there yet? JACC Cardiovasc Interv 2009;2:81-90.
• 3. Gürsoy OM, Astarcıoğlu MA, Gökdeniz T, Aykan AC, Bayram Z, Cakal B, et al. Severe mitral paravalvular leakage: echo-morphologic description of 47 patients from real-time three-dimensional transesophageal echocardiography perspective. Anadolu Kardiyol Derg 2013;13:633-40.
• 4. Taramasso M, Maisano F, Latib A, Denti P, Guidotti A, Sticchi A, et al. Conventional surgery and transcatheter closure via surgical transapical approach for paravalvular leak repair in high-risk patients: results from a single-centre experience. Eur Heart J Cardiovasc Imaging 2014;15:1161-7.
• 5. Yuksel UC, Tuzcu EM, Kapadia SR. Percutaneous closure of a posteromedial mitral paravalvular leak: the triple telescopic system. Catheter Cardiovasc Interv 2011;77:281-5.
• 6. Smolka G, Pysz P, Jasinski M, Roleder T, Peszek-Przybyła E, Ochala A, et al. Multiplug paravalvular leak closure using Amplatzer Vascular Plugs III: a prospective registry. Catheter Cardiovasc Interv 2016;87:478-87.
• 7. Calvert PA, Northridge DB, Malik IS, Shapiro L, Ludman P, Qureshi SA, et al. Percutaneous device closure of paravalvular leak: combined experience from the United Kingdom and Ireland. Circulation 2016;134:934-44.
• 8. Ozkan M, Gürsoy OM, Astarcıoğlu MA, Wunderlich N, Sievert H. Percutaneous closure of paravalvular mitral regurgitation with Vascular Plug III under the guidance of real-time three-dimensional transesophageal echocardiography. Turk Kardiyol Dern Ars 2012;40:632-41.