INCIDENCE OF PARAVALVULAR LEAKAGE IN PATIENTS UNDERGOING AORTIC VALVE REPLACEMENT
DOI:
https://doi.org/10.61164/rmnm.v12i1.2997Keywords:
Aortic valve implantation with catheter, Surgical aortic valve replacement, Paravalvular leakAbstract
Introduction: Aortic stenosis is a common degenerative condition in the elderly. Definitive treatment is usually surgical, with surgical aortic valve replacement (SAVR) or catheter aortic valve implantation (TAVI). Paravalvular leak (PVL) is a complication that can occur after valve replacement surgery, requiring intervention. Objective: To evaluate the incidence of paravalvular valve leak in patients who underwent SAVR and TAVI. Material and Method: We evaluated 25 studies published between January 2018 and November 2023 presenting groups of individuals who underwent SAVR or TAVI and had PVL as a complication. The main databases used were the Scielo and PubMed platforms. Results: It was observed that, shortly after discharge, 27% of the patients in question had some degree of paravalvular leak after TAVR, while among the patients who underwent AVRS, the incidence of PVV was 7.2%. After 6 months or more of discharge, 20.9% of TAVR patients still had TAVR, compared with 5.7% of SAVR patients.Conclusion: In the immediate and late postoperative periods, the incidence of PVL is lower in patients undergoing SAVR than in those undergoing TAVI, in all grades - mild, moderate and severe.
References
SAMPAIO, R. O. et al. Estenose Aórtica Importante na Presença de Baixo Gradiente e Função de Ejeção Normal. Arq Bras Cardiol Imagem cardiovasc, v.28 n.4, p.216-225, 2015.
KATZ, M.; TARASOUTCHI, F.; GRINBERG, M. Estenose aórtica grave em pacientes assintomáticos: o dilema do tratamento clínico versus cirúrgico. Arquivos Brasileiros de Cardiologia, v.95 n.4, p.541-546, 2010.
RÖSLER, Á. M. et al. Safety, Effectiveness, and Hemodynamic Performance of the Bovine Pericardium Organic Valvular Bioprosthesis. Brazilian Journal of Cardiovascular Surgery, v.38 n.6, 2023.
DAGENAIS, F. et al. Safety, efficacy, and hemodynamic performance of a stented bovine pericardial aortic valve bioprosthesis: Two-year analysis. The Journal of Thoracic and Cardiovascular Surgery, v.160 n.2, p.371-381.e4, 2020.
SALINAS, P. et a. Implantação percutânea de próteses valvulares aórticas: resultados de uma nova opção terapêutica na estenose aórtica com alto risco cirúrgico. Revista Portuguesa de Cardiologia, v. 31 n.2, p.143-149, 2012.
POZETTI, A. H.; RIBEIRO, H. B. Distúrbios de Condução após o Implante Transcateter de Válvula Aórtica: Desafio para mais 20 anos?. Arquivos Brasileiros de Cardiologia, v.119 n.4, p.531-532, 2022.
NGO, A. et al. Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses. European Heart Journal - Cardiovascular Imaging, v.19 n.1, p.39-46, 2018.
FREIXA, X. et al. Paravalvular Leakages after Surgical Aortic-Valve Replacement and after Transcatheter Aortic-Valve Implantation: Strategies to Increase the Success Rate of Percutaneous Closure. J Clin Med, v.11 n.11, p.2989, 2022.
LEAK Paravalvar: como tratar?. Albert Einstein, 2019. Disponível em: <https://www.einstein.br/intervencaocardiaca/leak-paravalvar>. Acesso em 28 de maio de 2023.
MODESTO, R.; ODONE, L. G. Leak paravalvar: Screening do candidato ideal. The Valve Club, 2023.
CHAU, K. H. et al. Paravalvular regurgitation after transcatheter aortic valve replacement in intermediate-risk patients: a pooled PARTNER 2 study. EuroIntervention, v.17 n.13, p.1053-1060, 2022.
LAZKANI, M. et al. Permanent pacemaker implantation and paravalvular leak rates following sutureless aortic valve operations. Journal of Cardiac Surgery, v.33 n.12, p.808-817, 2018.
STACHEL, G. et al. Fractal dimension of the aortic annulus: a novel predictor of paravalvular leak after transcatheter aortic valve implantation. The International Journal of Cardiovascular Imaging, v.38 n.11, p.2469-2478, 2022.
MAKKAR, R. R. et al. Self-expanding intra-annular versus commercially available transcatheter heart valves in high and extreme risk patients with severe aortic stenosis (PORTICO IDE): a randomised, controlled, non-inferiority trial. Lancet, v.396 n.10252, p.669-683, 2020.
RIZIK, D. G. et al. Long-term Outcomes of Transcatheter Aortic Valve Replacement With the Lotus Valve vs CoreValve/EvolutR: A Secondary Analysis of the REPRISE III Randomized Clinical Trial. JAMA Network Open, v.5 n.10, 2022.
BRANDÃO, C. M. et al. Análise da evolução tardia de 291 pacientes submetidos à substituição valvar por próteses metálicas. Brazilian Journal of Cardiovascular Surgery, v.10, p. 50-55, 1995.
LUCCHESE, F. A. et al. Estudo multicêntrico da bioprótese porcina Labcor. Rev. Bras. Cir. Cardiovasc, v. 3 n.3, p.169-174, 1988.
MUJTABA, S. S. et al. Early Clinical Results of Perceval Sutureless Aortic Valve in 139 Patients: Freeman Experience. Braz J Cardiovasc Surg, v.33 n.1, p8-14, 2018.
REINDERS, A.; DE VRIES, C. S.; JOUBERT, G. Pre-interventional assessment and calcification score of the aortic valve and annulus, with multi-detector CT, in transcatheter aortic valve implantation (TAVI) using the Medtronic CoreValve. South African Journal of Radiology, v.19 n.1, 2015.
JORGENSEN, T. H. et al. Eight-year outcomes for patients with aortic valve stenosis at low surgical risk randomized to transcatheter vs. surgical aortic valve replacement. Eur Heart J, v.42 n.20, p.2912-2919, 2021.
LEON, M. B. et al. Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery. N Engl J Med, v.363 n.17, p.1597-1607, 2010.
TOMII, D. et al. Valve-in-valve TAVI and risk of coronary obstruction: Validation of the VIVID classification. J Cardiovasc Comput Tomogr, v.17 n.2, p.105-111, 2023.
FORREST, J. K. et al. 2-Year Outcomes After Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients. J Am Coll Cardiol, v. 79 n.9, p.882-896, 2022.
FORREST, J. K. et al. Early Outcomes With the Evolut PRO Repositionable Self-Expanding Transcatheter Aortic Valve With Pericardial Wrap. JACC: Cardiovascular Interventions, v.11 n.2, p.160-168, 2018.
HAGAR, A. et al. Incidence, Predictors, and Outcome of Paravalvular Leak after Transcatheter Aortic Valve Implantation. Journal of Interventional Cardiology, v.2020, 2020.
POLLARI, F. et al. Risk factors for paravalvular leak after transcatheter aortic valve replacement. The Journal of Thoracic and Cardiovascular Surgery, v.157 n.4, p.1406-1415, 2019.
KI, Y.-J. et al. Optimal Oversizing Index Depending on Valve Type and Leakage-Proof Function for Preventing Paravalvular Leakage after Transcatheter Aortic Valve Implantation. Journal of Clinical Medicine, v.9 n.12, p.3936, 2020.
WITBERG, G. et al. Clinical outcomes of transcatheter aortic valve implantation in patients younger than 70 years rejected for surgery: the AMTRAC registry. EuroIntervention, v.17 n.16, p.1289-1297, 2022.
SONDERGAARD, L. et al. Durability of Transcatheter and Surgical Bioprosthetic Aortic Valves in Patients at Lower Surgical Risk. J Am Coll Cardiol, v.73 n.5, p.546-553, 2019.
FEISTRITZER, H. J. et al. Impact of Anesthesia Strategy and Valve Type on Clinical Outcomes After Transcatheter Aortic Valve Replacement. J Am Coll Cardiol, v.77 n.17, p.2204-2215, 2021.
SABIK, J. F. et al. One-year outcomes associated with a novel stented bovine pericardial aortic bioprosthesis. The Journal of Thoracic and Cardiovascular Surgery, v.156 n.4, p.1368-1377, 2018.
LAUFER, G. et al. Real-world 6-month outcomes of minimally invasive aortic valve replacement with the EDWARDS INTUITY Elite valve system. Interact Cardiovasc Thorac Surg, v.35 n.2, 2022.
SCHÄFER, U. et al. Safety and Performance Outcomes of a Self-Expanding Transcatheter Aortic Heart Valve: The BIOVALVE Trials. JACC Cardiovascular Interventions, v.13 n.2, p.157-166, 2020.
LI, F. et al. Structural Valve Deterioration after Transcatheter Aortic Valve Implantation Using J-Valve: A Long-Term Follow-Up. Ann Thorac Cardiovasc Surg, v.26 n.3, p.158-165, 2020.
FISCHLEIN, T. et al. Sutureless versus conventional bioprostheses for aortic valve replacement in severe symptomatic aortic valve stenosis. J Thorac Cardiovasc Surg, v.161 n.3, p.920-932, 2021.
SONDERGAARD, L. et al. Transcatheter Aortic Valve Replacement With a Repositionable Self-Expanding Prosthesis. Journal of the American College of Cardiology, v.72 n.23, p.2859-2867, 2018.
ABDELGHANI, M. et al. Bioprosthetic Valve Performance After Transcatheter Aortic Valve Replacement With Self-Expanding Versus Balloon-Expandable Valves in Large Versus Small Aortic Valve Annuli: Insights From the CHOICE Trial and the CHOICE-Extend Registry. JCC Cardiovasc Interv, v.11 n.24, p.2507–2518, 2018.
ASCH, F. M. et al. Hemodynamic and Echocardiographic Comparison of the Lotus and CoreValve Transcatheter Aortic Valves in Patients With High and Extreme Surgical Risk: An Analysis From the REPRISE III Randomized Controlled Trial. Circulation, v.137 n.24, p.2557–2567, 2018.
FORREST, J. K. et al. Three-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis. Journal of the American College of Cardiology, v.81 n.17, p.1663-1674, 2023.
GRAYBURN, P. A. et al. Effect of Baseline Aortic Regurgitation on Mortality in Patients Treated With Transcatheter or Surgical Aortic Valve Replacement (from the CoreValve US Pivotal Trial). The American Journal of Cardiology, v.122 n.9, p.1527-1535, 2018.
LEI, W.-H. et al. Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis Having Coronary Cusp Fusion versus Mixed Cusp Fusion Nonraphe Bicuspid Aortic Valve. Journal of Interventional Cardiology, v.2019, 2019.
LEON, M. B. et al. Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery. N Engl J Med, v.363 n.17, p.1597-1607, 2010
MAKKAR, R. R. et al. Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement. New England Journal of Medicine, v.382 n.9, p.799-809, 2020.
MATTEUCCI, M. et al. Early Aortic Paravalvular Leak After Conventional Cardiac Valve Surgery: A Single-Center Experience. The Annals of Thoracic Surgery, v.109 n.2, p.517-525, 2020.
OKUNO, T. et al. 5-Year Outcomes With Self-Expanding vs Balloon-Expandable Transcatheter Aortic Valve Replacement in Patients With Small Annuli. JACC Cardiovascular Interventions, v.16 n.4, p.429-440, 2023.
ROOIJAKKERS, M. J. P. et al. Diastolic delta best predicts paravalvular regurgitation after transcatheter aortic valve replacement as assessed by cardiac magnetic resonance: the APPOSE trial. European Heart Journal Cardiovascular Imaging, v.24 n.8, p.1072–1081, 2023.
VAN MIEGHEM, N. M. et al. Self-expanding Transcatheter vs Surgical Aortic Valve Replacement in Intermediate-Risk Patients: 5-Year Outcomes of the SURTAVI Randomized Clinical Trial. JAMA Cardiology, v.7 n.10, p.1000-1008, 2022.
WAKSMAN, R. et al. Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic Severe Bicuspid Aortic Valve Stenosis. J Am Coll Cardiol, v.72 n.18, p.2095-2105, 2018.
YONG, G. et al. Performance and Safety of Transfemoral TAVI With SAPIEN XT in Australian Patients With Severe Aortic Stenosis at Intermediate Surgical Risk: SOLACE-AU Trial. Heart Lung Circ, v.29 n.12, p.1839-1846, 2020.
ABDEL-WAHAB, M. et al. 5-Year Outcomes After TAVR With Balloon-Expandable Versus Self-Expanding Valves: results From the CHOICE Randomized Clinical Trial. JACC Cardiovasc Interv, v.13 n.9, p.1071-1082, 2020.
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