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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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 documento: artigo
Data de publicação:2024
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:dnet:uabarcelona_::7f06abac5ec079ff836ce61336796e1a
Acesso em linha:https://ddd.uab.cat/record/327683
https://dx.doi.org/urn:doi:10.1016/j.cjca.2023.11.025
Access Level:Acceso aberto
Palavra-chave:Mitral valve
Paravalvular leak
Percutaneous closure
Survival
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spelling Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical OutcomesBelahnech, Yassin|||0000-0003-0723-1023Martí Aguasca, GerardGarcía del Blanco, Bruno|||0000-0002-4527-1600Ródenas-Alesina, Eduard|||0000-0003-1638-7820González-Alujas, TeresaGutiérrez García-Moreno, LauraGalian-Gay, Laura|||0000-0001-6828-5928Fernández-Galera, Rubén|||0000-0002-3870-9360Otaegui, Imanol|||0000-0001-6594-3139Serra, ViçensBellera Gotarda, Neus|||0000-0002-1040-0900Serra, BernatCalabuig Goena, Alvaro|||0000-0001-8388-4988Calvo-Barceló, MariaBarrabés, José A.|||0000-0001-7062-6277Ferreira-Gonzalez, Ignacio|||0000-0002-1208-5561Mitral valveParavalvular leakPercutaneous closureSurvivalBackground: 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. 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501AMhttp://purl.org/coar/version/c_ab4af688f83e57aainfo:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/327683https://dx.doi.org/urn:doi:10.1016/j.cjca.2023.11.025reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengInstituto de Salud Carlos III https://doi.org/10.13039/501100004587 CM22/00242open accesshttp://purl.org/coar/access_right/c_abf2Aquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.https://rightsstatements.org/vocab/InC/1.0/info:eu-repo/semantics/openAccessoai:dnet:uabarcelona_::7f06abac5ec079ff836ce61336796e1a2026-06-06T12:50:31Z
dc.title.none.fl_str_mv Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes
title Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes
spellingShingle Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes
Belahnech, Yassin|||0000-0003-0723-1023
Mitral valve
Paravalvular leak
Percutaneous closure
Survival
title_short Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes
title_full Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes
title_fullStr Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes
title_full_unstemmed Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes
title_sort Impact of a Successful Percutaneous Mitral Paravalvular Leak Closure on Long-term Major Clinical Outcomes
dc.creator.none.fl_str_mv 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
author Belahnech, Yassin|||0000-0003-0723-1023
author_facet 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
author_role author
author2 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
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Mitral valve
Paravalvular leak
Percutaneous closure
Survival
topic Mitral valve
Paravalvular leak
Percutaneous closure
Survival
description 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.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
AM
http://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/327683
https://dx.doi.org/urn:doi:10.1016/j.cjca.2023.11.025
url https://ddd.uab.cat/record/327683
https://dx.doi.org/urn:doi:10.1016/j.cjca.2023.11.025
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 CM22/00242
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://rightsstatements.org/vocab/InC/1.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://rightsstatements.org/vocab/InC/1.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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repository.mail.fl_str_mv
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