Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes

Background: Percutaneous mitral paravalvular leak (PVL) closure techniques are an effective and safe alternative to surgical treatment, but data regarding long-term outcomes are scarce. We aim to describe the impact of successful percutaneous mitral PVL closure on long-term outcomes. Methods: All co...

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Detalles Bibliográficos
Autores: Belahnech, Yassin|||0000-0003-0723-1023, Martí Aguasca, Gerard, García del Blanco, Bruno|||0000-0002-4527-1600, Ródenas-Alesina, Eduard|||0000-0003-1638-7820, González-Alujas, Teresa, Gutiérrez García-Moreno, Laura, Galian-Gay, Laura|||0000-0001-6828-5928, Fernández-Galera, Rubén|||0000-0002-3870-9360, Otaegui, Imanol|||0000-0001-6594-3139, Serra, Viçens, Bellera Gotarda, Neus|||0000-0002-1040-0900, Serra, Bernat, Calabuig Goena, Alvaro|||0000-0001-8388-4988, Calvo-Barceló, Maria, Barrabés, José A.|||0000-0001-7062-6277, Ferreira-Gonzalez, Ignacio|||0000-0002-1208-5561
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::7f06abac5ec079ff836ce61336796e1a
Acceso en línea:https://ddd.uab.cat/record/327683
https://dx.doi.org/urn:doi:10.1016/j.cjca.2023.11.025
Access Level:acceso abierto
Palabra clave:Mitral valve
Paravalvular leak
Percutaneous closure
Survival
Descripción
Sumario:Background: Percutaneous mitral paravalvular leak (PVL) closure techniques are an effective and safe alternative to surgical treatment, but data regarding long-term outcomes are scarce. We aim to describe the impact of successful percutaneous mitral PVL closure on long-term outcomes. Methods: All consecutive patients in whom a first-attempt percutaneous mitral PVL closure was performed in a single tertiary centre between January 2010 and October 2021 were included. Clinical variables, procedural details, and procedural success were collected. Patients were classified based on procedural success, defined as no more than mild residual leak. All-cause mortality was the primary endpoint. Cardiovascular death and heart failure hospitalizations (HFHs) were key secondary endpoints. Results: Ninety patients (median age 72.5 years [66.0-78.4]; median EuroSCORE-II 8.2 [5.3-12.46]) were included. Although reduction of at least 1 degree in PVL severity was achieved in 82 (91.1%), procedural success was achieved in 47 (52.2%). Chronic kidney disease, previous surgery for PVL, and the presence of multiple jets were independently associated with procedural failure. After a median follow-up of 3.2 (1.2-5.2) years, mortality rate was higher in the procedural failure group (27.3 per 100 patients-years) compared with the group with successful closure (8.2 per 100 patient-years). Procedural failure was associated with all-cause death (adjusted hazard ratio [aHR], 2.59; 95% confidence interval [CI], 1.41-4.78), cardiovascular death (aHR, 3.53; 95% CI, 1.67-7.49) and HFH (aHR, 3.27; 95% CI,1.72-6.20). Conclusions: A successful reduction in PVL to mild or absent is associated with improved rates of all-cause death, cardiovascular death, and HFHs.

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