DOI: 10.4244/EIJV8I5A97

Site of paravalvular leak after mitral valve replacement influences leaflet blockage by Amplatzer device

Nawwar Al-Attar1*, PhD, FRCS, FETCS; Ghada Al-Salih², MD, MSc; Soleiman Alkhoder1, MD; Costin Radu1, MD; Richard Raffoul1, MD; Patrick Nataf1, MD

Transcatheter closure of paravalvular or paraprosthetic leaks (PVL) is an alternative repair strategy to surgery in patients with isolated PVL, or at a very high risk of redo valve replacement.1 However, the occluder can lead to the dysfunction of valve leaflets of the mechanical valves. We studied the relationship of the anatomical location of PVL after mechanical mitral valve replacement on dysfunction of leaflets induced by the occluder after transcatheter closure. In a pig’s heart model, a St. Jude Medical® Masters bileaflet mitral valve (St. Jude Medical [SJM], St. Paul, MN, USA) was implanted using exactly the same technique as employed in humans. A gap was created and an Amplatzer occlusion device was surgically positioned to close the paravalvular gap. The mobility of the leaflets was examined according to different orientations of the mechanical prosthesis. The region of the pivots is elevated in the SJM prosthesis, which seems to confer protection by distancing the leaflets from the device which led to minimal interference (Figure 1) as compared to complete obstruction of the leaflet when the device was located at 90° from the site of pivots (Figure 2).

Figure 1. Amplatzer device is placed at the zone of the pivots of the mechanical valve. Minimal interference is observed.

Figure 2. Amplatzer device is placed at 90° from the zone of the pivots. Complete obstruction of the juxtapositional leaflet is observed by the occluder device.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Volume 8 Number 5
Sep 28, 2012
Volume 8 Number 5
View full issue


Key metrics

Suggested by Cory

10.4244/EIJV12SXA11 May 16, 2016
Catheter-based treatment of paravalvular leaks
Taramasso M et al
free

10.4244/EIJV17I9A121 Oct 20, 2021
Transcatheter paravalvular leak closure: catch me if you can
Pilgrim T and Okuno T
free

CLINICAL RESEARCH

10.4244/EIJV11I10A237 Feb 19, 2016
Early experience of percutaneous paravalvular leak closure using a novel Occlutech occluder
Goktekin O et al
free

Image – Interventional flashlight

10.4244/EIJ-D-19-01122 Oct 9, 2020
The retro-antegrade approach to paravalvular leak closure after transcatheter aortic valve replacement
So C et al
free

Clinical research

10.4244/EIJ-D-22-01110 Aug 7, 2023
Percutaneous paravalvular leak closure after transcatheter aortic valve implantation: the international PLUGinTAVI Registry
Flores-Umanzor E et al
free
Trending articles
151.43

State-of-the-Art

10.4244/EIJ-D-22-00776 Apr 3, 2023
Computed tomographic angiography in coronary artery disease
Serruys PW et al
free
55.9

Clinical research

10.4244/EIJ-D-22-00621 Feb 20, 2023
Long-term changes in coronary physiology after aortic valve replacement
Sabbah M et al
free
54.9

Expert review

10.4244/EIJ-D-21-01010 Jun 24, 2022
Device-related thrombus following left atrial appendage occlusion
Simard T et al
free
43.75

Clinical Research

10.4244/EIJ-D-21-01091 Aug 5, 2022
Lifetime management of patients with symptomatic severe aortic stenosis: a computed tomography simulation study
Medranda G et al
free
39.95

Clinical research

10.4244/EIJ-D-22-00558 Feb 6, 2023
Permanent pacemaker implantation and left bundle branch block with self-expanding valves – a SCOPE 2 subanalysis
Pellegrini C et al
free
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 7.6
2023 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2024)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2024 Europa Group - All rights reserved