PMID- 29024359
OWN - NLM
STAT- MEDLINE
DCOM- 20190423
LR  - 20200225
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Print)
IS  - 1522-1946 (Linking)
VI  - 91
IP  - 5
DP  - 2018 Apr 1
TI  - Paravalvular leak closure under intracardiac echocardiographic guidance.
PG  - 958-965
LID - 10.1002/ccd.27318 [doi]
AB  - OBJECTIVES: The objective of this study was to determine the safety and efficacy 
      of intracardiac echocardiography (ICE) to guide percutaneous paravalvular leak 
      (PVL) closure. BACKGROUND: PVL following surgical valve replacement occurs in 
      2%-15% of patients. Percutaneous treatment is an accepted management strategy in 
      patients deemed to be too high risk for redo surgery. This is most commonly 
      performed with transesophageal (TOE) guidance requiring general anesthesia that 
      both potentially further increase the risk of intervention. ICE can be used to 
      guide intervention, facilitating procedures to be performed under local 
      anesthesia without esophageal intubation potentially making procedures shorter 
      and safer and further enabling the treatment of patients that may have been 
      turned down for intervention. METHODS: All patients that underwent ICE-guided 
      percutaneous transcatheter PVL closure between 2006 and 2016 at the John 
      Radcliffe Hospital, Oxford, United Kingdom were retrospectively analyzed. 
      RESULTS: Twenty-one procedures were performed in 18 patients during the study 
      period. Fourteen patients (77.8%) underwent successful ICE guided PVL closure. 
      There were no ICE-related complications. Eleven patients (78.6%) reported 
      symptomatic improvement of at least one New York Heart Association (NYHA) Class 
      and the remaining 3 patients had no change. No patient demonstrated objective 
      evidence of persistent hemolysis following successful closure. There was one 
      death within 30 days of the procedure and 1 year survival was 71.4%. CONCLUSIONS: 
      Percutaneous paravalvular leak closure guided by ICE without the requirement of 
      general anesthesia is feasible, safe, and associated with acceptable procedural 
      success rates.
CI  - (c) 2017 Wiley Periodicals, Inc.
FAU - Ruparelia, Neil
AU  - Ruparelia N
AUID- ORCID: 0000-0003-3968-2750
AD  - Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley 
      Way, Oxford OX3 9DU, United Kingdom.
FAU - Cao, Jacob
AU  - Cao J
AD  - Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley 
      Way, Oxford OX3 9DU, United Kingdom.
FAU - Newton, James D
AU  - Newton JD
AD  - Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley 
      Way, Oxford OX3 9DU, United Kingdom.
FAU - Wilson, Neil
AU  - Wilson N
AD  - Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley 
      Way, Oxford OX3 9DU, United Kingdom.
AD  - Department of Paediatrics-Cardiology, Children's Hospital Colorado, Aurora, 
      Colorado 80045.
FAU - Daniels, Matthew J
AU  - Daniels MJ
AD  - Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley 
      Way, Oxford OX3 9DU, United Kingdom.
FAU - Ormerod, Oliver J
AU  - Ormerod OJ
AD  - Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley 
      Way, Oxford OX3 9DU, United Kingdom.
LA  - eng
GR  - 098519/Wellcome Trust/United Kingdom
PT  - Journal Article
DEP - 20171010
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/diagnostic imaging/physiopathology/*surgery
MH  - Aortic Valve Insufficiency/diagnostic imaging/etiology/physiopathology/*therapy
MH  - Aortography
MH  - Cardiac Catheterization/*methods
MH  - Echocardiography/*methods
MH  - England
MH  - Feasibility Studies
MH  - Female
MH  - Heart Valve Prosthesis Implantation/*adverse effects/instrumentation
MH  - Humans
MH  - Male
MH  - Mitral Valve/diagnostic imaging/physiopathology/*surgery
MH  - Mitral Valve Insufficiency/diagnostic imaging/etiology/physiopathology/*therapy
MH  - Predictive Value of Tests
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ultrasonography, Interventional/*methods
PMC - PMC6588530
MID - EMS83420
OTO - NOTNLM
OT  - aortic valve disease
OT  - intracardiac echocardiography
OT  - mitral valve disease
OT  - paravalvalvular leak
OT  - structural heart disease intervention
EDAT- 2017/10/13 06:00
MHDA- 2019/04/24 06:00
PMCR- 2019/06/21
CRDT- 2017/10/13 06:00
PHST- 2017/05/08 00:00 [received]
PHST- 2017/08/05 00:00 [accepted]
PHST- 2017/10/13 06:00 [pubmed]
PHST- 2019/04/24 06:00 [medline]
PHST- 2017/10/13 06:00 [entrez]
PHST- 2019/06/21 00:00 [pmc-release]
AID - 10.1002/ccd.27318 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2018 Apr 1;91(5):958-965. doi: 10.1002/ccd.27318. 
      Epub 2017 Oct 10.