Author + information
- Received June 12, 2011
- Revision received July 15, 2011
- Accepted July 19, 2011
- Published online November 15, 2011.
- ↵⁎Reprint requests and correspondence:
Dr. Paul Sorajja, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota 55902
Objectives The goal of this study was to determine the long-term clinical efficacy of percutaneous repair of paravalvular prosthetic regurgitation.
Background Percutaneous repair has emerged as an effective therapy for patients with paravalvular prosthetic regurgitation.
Methods We retrospectively identified 126 patients who underwent catheter-based treatment of symptomatic prosthetic paravalvular regurgitation. Patients were contacted for symptoms, clinical events, and vital status.
Results The 3-year estimate for survival was 64.3% (95% confidence interval: 52.1% to 76.8%). Mortality occurred due to cardiac, noncardiac, and unknown causes in 9.5%, 7.1%, and 5.6% of patients, respectively. Among survivors, 72% of patients who had presented with heart failure were free of severe symptoms and need for cardiac surgery. Severity of residual regurgitation was not related to overall survival but was an important determinant of other clinical events. For those with no, mild, or moderate or severe residual regurgitation, 3-year estimate of survival free of death or need for surgery was 63.3%, 58.3%, and 30.3% (p = 0.01), respectively.
Conclusions Percutaneous repair of paravalvular prosthetic regurgitation can lead to durable symptom relief in selected patients. Nonetheless, mortality remains significant in symptomatic patients with paravalvular prosthetic regurgitation. Long-term clinical efficacy is highly dependent on residual regurgitation.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 12, 2011.
- Revision received July 15, 2011.
- Accepted July 19, 2011.
- American College of Cardiology Foundation