How should i treat recurrent severe paravalvular leakage after successful interventional closure of a symptomatic paravalvular leak with four plug devices following complicated bioprosthetic aortic valve replacement? the importance of closely monitoring patients after interventional procedures

Nicolas Werner, Caroline Kilkowski, Boris Fraiture, Uwe Zeymer, Ralf Zahn, Sameer Gafoor, Sameer Gafoor, Gianfranco Butera

Research output: Contribution to journalArticle

Abstract

© Europa Digital & Publishing 2017. All rights reserved. BACKGROUND: A few weeks after complicated redo bioprosthetic aortic valve replacement for infective endocarditis of a bioprosthesis, a 74-year-old male patient developed severe and symptomatic aortic valve regurgitation due to a large paravalvular leak (PVL) and underwent successful interventional closure of the PVL with sequential implantation of four AMPLATZER Vascular Plug III devices. Despite the initial success of the procedure, with a significant decrease in AR (grade II) and clinical stabilisation of the patient, he was re-admitted to hospital six months later due to advanced signs of heart failure. 3D-TOE again showed severe paravalvular AR next to the implanted plugs. INVESTIGATION: Transthoracic echocardiography, 3D-TOE, laboratory tests, cardiac catheterisation including aortography. DIAGNOSIS: New severe PVL after interventional PVL closure after complicated bioprosthetic aortic valve replacement. MANAGEMENT: Interventional PVL closure.
Original languageEnglish
Pages (from-to)888-892
Number of pages5
JournalEuroIntervention
Volume13
Issue number7
DOIs
Publication statusPublished - Sep 1 2017

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Physiologic Monitoring
Aortic Valve
Bioprosthesis
Aortography
Equipment and Supplies
Aortic Valve Insufficiency
Cardiac Catheterization
Endocarditis
Blood Vessels
Echocardiography
Heart Failure

Keywords

  • Catheter-based closure
  • Interventional closure
  • Paravalvular leak
  • Plug

Cite this

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title = "How should i treat recurrent severe paravalvular leakage after successful interventional closure of a symptomatic paravalvular leak with four plug devices following complicated bioprosthetic aortic valve replacement? the importance of closely monitoring patients after interventional procedures",
abstract = "{\circledC} Europa Digital & Publishing 2017. All rights reserved. BACKGROUND: A few weeks after complicated redo bioprosthetic aortic valve replacement for infective endocarditis of a bioprosthesis, a 74-year-old male patient developed severe and symptomatic aortic valve regurgitation due to a large paravalvular leak (PVL) and underwent successful interventional closure of the PVL with sequential implantation of four AMPLATZER Vascular Plug III devices. Despite the initial success of the procedure, with a significant decrease in AR (grade II) and clinical stabilisation of the patient, he was re-admitted to hospital six months later due to advanced signs of heart failure. 3D-TOE again showed severe paravalvular AR next to the implanted plugs. INVESTIGATION: Transthoracic echocardiography, 3D-TOE, laboratory tests, cardiac catheterisation including aortography. DIAGNOSIS: New severe PVL after interventional PVL closure after complicated bioprosthetic aortic valve replacement. MANAGEMENT: Interventional PVL closure.",
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T1 - How should i treat recurrent severe paravalvular leakage after successful interventional closure of a symptomatic paravalvular leak with four plug devices following complicated bioprosthetic aortic valve replacement? the importance of closely monitoring patients after interventional procedures

AU - Werner, Nicolas

AU - Kilkowski, Caroline

AU - Fraiture, Boris

AU - Zeymer, Uwe

AU - Zahn, Ralf

AU - Gafoor, Sameer

AU - Gafoor, Sameer

AU - Butera, Gianfranco

PY - 2017/9/1

Y1 - 2017/9/1

N2 - © Europa Digital & Publishing 2017. All rights reserved. BACKGROUND: A few weeks after complicated redo bioprosthetic aortic valve replacement for infective endocarditis of a bioprosthesis, a 74-year-old male patient developed severe and symptomatic aortic valve regurgitation due to a large paravalvular leak (PVL) and underwent successful interventional closure of the PVL with sequential implantation of four AMPLATZER Vascular Plug III devices. Despite the initial success of the procedure, with a significant decrease in AR (grade II) and clinical stabilisation of the patient, he was re-admitted to hospital six months later due to advanced signs of heart failure. 3D-TOE again showed severe paravalvular AR next to the implanted plugs. INVESTIGATION: Transthoracic echocardiography, 3D-TOE, laboratory tests, cardiac catheterisation including aortography. DIAGNOSIS: New severe PVL after interventional PVL closure after complicated bioprosthetic aortic valve replacement. MANAGEMENT: Interventional PVL closure.

AB - © Europa Digital & Publishing 2017. All rights reserved. BACKGROUND: A few weeks after complicated redo bioprosthetic aortic valve replacement for infective endocarditis of a bioprosthesis, a 74-year-old male patient developed severe and symptomatic aortic valve regurgitation due to a large paravalvular leak (PVL) and underwent successful interventional closure of the PVL with sequential implantation of four AMPLATZER Vascular Plug III devices. Despite the initial success of the procedure, with a significant decrease in AR (grade II) and clinical stabilisation of the patient, he was re-admitted to hospital six months later due to advanced signs of heart failure. 3D-TOE again showed severe paravalvular AR next to the implanted plugs. INVESTIGATION: Transthoracic echocardiography, 3D-TOE, laboratory tests, cardiac catheterisation including aortography. DIAGNOSIS: New severe PVL after interventional PVL closure after complicated bioprosthetic aortic valve replacement. MANAGEMENT: Interventional PVL closure.

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KW - Plug

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