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J Thorac Cardiovasc Surg 2008;136:1076-1077
© 2008 The American Association for Thoracic Surgery

Brief Communication

Pitfalls in catheter-based interventions to treat paravalvular leaks

Andreas Bairaktaris, MD, Nikolaus A. Haas, MD, Dirk Seifert, MD, Rainer Schaeffler, MD, Heinrich Koertke, MD, Soren Schenk, MD*, Reiner Koerfer, MD

Department of Cardiovascular Surgery, Heart Center NRW, Bad Oeynhausen, Germany

Received for publication August 14, 2007; accepted for publication August 23, 2007.

* Address for reprints: Soren Schenk, MD, Cardiovascular Surgery, Heart Center NRW, Georgstrasse 11, 32545 Bad Oeynhausen, Germany. (Email: sschenk@arcor.de).

The first 20% of the full text of this article appears below.

Paravalvular leaks of prosthetic heart valves can be observed at a rate as great as 1.4% leaks/patient-year.1Go Surgical correction can be performed with low mortality in most instances of clinically relevant regurgitation or hemolysis.2Go More recently, interventional cardiologic techniques are of growing interest. This report depicts 3 patients who required surgical treatment for interventional complications. Current challenges and indications for this evolving technology are discussed.

Clinical Summaries

PATIENT 1. A 73-year-old man was referred for grade III mitral regurgitation caused by a persistent paravalvular leak. The patient had undergone implantation of a bioprosthesis in the mitral position at 53 years of age. This prosthesis was replaced when the patient was 66 years old with a mechanical prosthesis because of valve degeneration. A relevant paravalvular leak was diagnosed 6 years after the last valve exchange and prompted 2 attempts at interventional closure with the Amplatzer PDA Occluder Device (AGA Medical Corporation, Golden Valley, Minn). The patient had increasing hemolysis, and his clinical status progressively declined within the subsequent 2 years. . . . [Full Text of this Article]






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