Transcatheter mitral paravalvular closure: a single centre experience with techniques and outcomes

Background: In patients with symptomatic mitral PVL, successful transcatheter reduction of the PVL to less than mild is associated with significant improvement in short- and midterm survival. Objectives: In this study, we present our single-centre, same operators’ experience on percutaneous paravalvular leak closure with techniques and outcomes. Methods: In this retrospective observational designed study, we retrieved hospital records of patients with a surgical history of mechanical or biological prosthetic valve replacement and who subsequently underwent transcatheter mitral paravalvular leak closure (TMPLC). All procedures were performed by the same operators. Results: A total of 45 patients with 58 PVDs underwent TMPLC using 60 devices. All patients had moderate or severe mitral paravalvular regurgitation associated with symptomatic HF (15.6%), clinically significant haemolytic anaemia (57.8%) or both (26.7%). The technical success rate was 91.4%, with 53 defects successfully occluded. The clinical success rate was 75.6%. Among the clinical success parameters, the preprocedural median ejection fraction increased from 45% (35–55) to 50% (40–55) (p =.04). Mitral gradients decreased from max/mean 18/8 mmHg to max/mean 16/7 mmHg; p =.02). Haemoglobin levels increased from 9.9 (8.5–11.1) to 11.1 (3–13); p =.003. LDH levels decreased from 875 (556–1125) to 435 (314–579); p: <.001. All-cause 30-day and in-hospital mortality rates were the same at 8.9%. Conclusion: This single-centre study with a limited number of patients confirmed that TMPLC is a safe and effective procedure to improve symptoms and severity of PVL.