Perivalvular Leakage: Percutaneous Treatment Options

Abstract

Widespread diffusion of biomedical technologies and interventional options in developed countries have progressively changed the natural history and improved the dismal prognosis of patients with degenerative cardiovascular diseases, leading to an increasing contingent of surviving patients that age with different and complex comorbidities. Furthermore, invasive treatments may in turn generate unique complications and novel pathological conditions often requiring demanding approaches. In this view, prosthetic paravalvular leakage (PVL) represents a paradigm of a surgically induced pathology that may be acquired early or late after valvular surgery and, although the majority of cases are mild to moderate, may also be life-threatening in its severe forms. Redo surgery, when medical therapy fails to maintain heart compensation or good quality of life, has been the established destination treatment for severe cases. However, as previously stated, the increasing age and complexity of patients as well as the high risk of failure when suturing a compromised tissue have raised the need to develop feasible and effective percutaneous alternatives.