@Article{Smolka2016,
journal="Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej",
issn="1734-9338",
volume="12",
number="2",
year="2016",
title="Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry",
abstract=" Introduction : Transcatheter paravalvular leak closure (TPVLC) has become an established treatment option but is mostly performed with off-label use of different non-dedicated occluders. The first one specifically designed for TPVLC is the paravalvular leak device (PLD – Occlutech).   Aim : We present initial short-term results of a prospective registry intended to assess the safety and efficacy of TPVLC with PLD.   Material and methods : We screened patients with paravalvular leak (PVL) after surgical valve replacement (SVR). Heart failure symptoms and/or hemolytic anemia were indications for TPVLC. Patients were selected according to PVL anatomy by RT 3D TEE. Only those considered appropriate for closure with a single PLD were enrolled. The procedures were performed via transvascular or transapical access using type W (waist) PLDs only.   Results : Thirty patients with 34 PVLs (18 aortic, 16 mitral) were included. We implanted 35 PLDs with a total device success rate of 94.3% (100% for aortic, 88.2% for mitral). The procedural success rate, encompassing device success without in-hospital complications, was 94.1% (100% for aortic, 93.8% for mitral). During the follow-up period we recorded an increase of hemoglobin concentration (3.9 to 4.1 g/dl), red blood count (11.6 to 12.2 M/mm3) and functional improvement by NYHA class.   Conclusions : Paravalvular leak device type W is a promising TPVLC device, but meticulous preselection of patients based on imaging of PVL anatomy is a prerequisite. A PLD should only be chosen for channels shorter than 5 mm. Size of the device should match the PVL cross-sectional area without any oversizing. Such an approach facilitates high device and procedural success rates.",
author="Smolka, Grzegorz
and Pysz, Piotr
and Kozłowski, Michał
and Jasiński, Marek
and Gocoł, Radosław
and Roleder, Tomasz
and Kargul, Agnieszka
and Ochała, Andrzej
and Wojakowski, Wojciech",
pages="128--134",
doi="10.5114/aic.2016.59363",
url="http://dx.doi.org/10.5114/aic.2016.59363"
}