DTA

Digital Theses Archive

 

Tesi etd-12232021-003059

Type of thesis
Master univ. II liv.
Author
QUADRI, GIORGIO
E-mail address
giorgio_quadri@yahoo.it
URN
etd-12232021-003059
Title
Bioprosthetic aortic paravalvular leak closure: successful percutaneous treatment guided by transthoracic echocardiography
Structure
Istituto di Scienze della Vita
Course
Corsi Alta Formazione - PERCUTANEOUS INTERVENTIONAL TREATMENT OF STRUCTURAL HEART DISEASES
Committee
relatore Dott. BERTI, SERGIO
Presidente Prof. PASSINO, CLAUDIO
Keywords
  • hemolysis
  • paravalvular leak
  • percutaneous closure
Exam session start date
21/01/2022;
Availability
completa
Abstract
Paravalvular leak represents a common complication of heart valve intervention and no randomized data comparing surgical repair to percutaneous intervention are currently available. We reported the case of a 79-year-old man admitted to the Cardiology ward with the diagnoses of decompensated heart failure and anemia. One year before, he underwent cardiac surgery for severe aortic stenosis and a 23 mm Magna Ease bioprosthesis was implanted. The transthoracic echocardiography at admission showed a bioprosthetic aortic paravalvular leak leading to mild-to-moderate valvular regurgitation. Laboratory tests confirmed that the anemia was caused by hemolysis. The patient's symptoms improved with medical treatment optimization, but the anemia still remained despite red blood cell transfusion. The patient refused surgical reintervention but accepted to undergo percutaneous closure of the paravalvular leak. The procedure was guided by transthoracic echocardiography and a single AVP III plug was successfully positioned. A very small leak with trivial residual aortic regurgitation remained. The procedural success was also confirmed by patient’s clinical improvement at follow-up.
Files