PMID- 27143596
OWN - NLM
STAT- MEDLINE
DCOM- 20190128
LR  - 20190128
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 91
IP  - 1
DP  - 2018 Jan 1
TI  - Successful percutaneous paravalvular leak closure followed by transfemoral aortic
      lotus valve-in-valve implantation in a degenerated surgical bioprosthesis.
PG  - 169-174
LID - 10.1002/ccd.26552 [doi]
AB  - Bioprosthesis degeneration is a relevant clinical issue that is increasingly
      developing with the higher expectancy of life. Its treatment may be further
      complicated by the presence of paravalvular leaks, which are usually consequence 
      of tissue friability, annular calcification, and infection. The surgical
      treatment of such complex conditions may be too risky, so percutaneous techniques
      in selected centers are becoming an attracting option. We report the case of a
      65-year-old gentleman with a previous aortic valve replacement (Perimount n.25)
      who was admitted with worsening heart failure and transoesophageal evidence of
      severe intraprosthetic regurgitation and a large paravalvular leak. Since he was 
      judged at too high risk for surgery, he was treated by a fully percutaneous
      approach. First, he had his large paravalvular leak closed by implantation of two
      plugs from both retrograde and anterograde routes (arterial-venous loop created).
      After one month, he underwent a "valve-in-valve" transcatheter aortic valve
      implantation with a fully repositionable Lotus 23 mm valve, which was able to
      restore a completely normal aortic valve function and let to a dramatic
      improvement of his functional status at 6-month follow-up (from NYHA IV to NYHA
      I), when a transthoracic echocardiogram also confirmed the absence of any aortic 
      regurgitation. This case shows how a tailored step-by-step fully percutaneous
      strategy is safe and feasible in high-risk patients with both bioprosthesis
      degeneration and large paravalvular leaks. This novel opportunity would need to
      be better evaluated in properly addressed long-term clinical studies. (c) 2016
      Wiley Periodicals, Inc.
CI  - (c) 2016 Wiley Periodicals, Inc.
FAU - Nerla, Roberto
AU  - Nerla R
AD  - Interventional Cardiology Unit, GVM Maria Cecilia Hospital, Cotignola, Italy.
FAU - Cremonesi, Alberto
AU  - Cremonesi A
AD  - Interventional Cardiology Unit, GVM Maria Cecilia Hospital, Cotignola, Italy.
FAU - Castriota, Fausto
AU  - Castriota F
AD  - Interventional Cardiology Unit, GVM Maria Cecilia Hospital, Cotignola, Italy.
LA  - eng
PT  - Case Reports
PT  - Video-Audio Media
DEP - 20160503
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  - Aortic Valve/diagnostic imaging/physiopathology/*surgery
MH  - Aortic Valve Insufficiency/diagnostic imaging/etiology/physiopathology/*surgery
MH  - *Bioprosthesis
MH  - Cardiac Catheterization/*instrumentation
MH  - Echocardiography, Doppler, Color
MH  - Echocardiography, Transesophageal
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/adverse effects/*instrumentation
MH  - Humans
MH  - Male
MH  - Prosthesis Design
MH  - *Prosthesis Failure
MH  - Radiography, Interventional
MH  - Recovery of Function
MH  - Transcatheter Aortic Valve Replacement/*instrumentation
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *aortic valve disease
OT  - *paravalvular leak
OT  - *percutaneous intervention
OT  - *transcatheter valve implantation
EDAT- 2016/05/05 06:00
MHDA- 2019/01/29 06:00
CRDT- 2016/05/05 06:00
PHST- 2016/01/03 00:00 [received]
PHST- 2016/02/21 00:00 [revised]
PHST- 2016/03/17 00:00 [accepted]
PHST- 2016/05/05 06:00 [pubmed]
PHST- 2019/01/29 06:00 [medline]
PHST- 2016/05/05 06:00 [entrez]
AID - 10.1002/ccd.26552 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2018 Jan 1;91(1):169-174. doi: 10.1002/ccd.26552.
      Epub 2016 May 3.