Imperial College London
Portrait Picture

DrVasileiosPanoulas

Faculty of Medicine, National Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
//

Contact

 

v.panoulas

 
 
//

Location

 

Guy Scadding BuildingRoyal Brompton Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Taramasso:2014:ehjci/jeu105,
author = {Taramasso, M and Maisano, F and Latib, A and Denti, P and Guidotti, A and Sticchi, A and Panoulas, V and Giustino, G and Pozzoli, A and Buzzatti, N and Cota, L and De, Bonis M and Montorfano, M and Castiglioni, A and Blasio, A and La, Canna G and Colombo, A and Alfieri, O},
doi = {ehjci/jeu105},
journal = {Eur Heart J Cardiovasc Imaging},
pages = {1161--1167},
title = {Conventional surgery and transcatheter closure via surgical transapical approach for paravalvular leak repair in high-risk patients: results from a single-centre experience.},
url = {http://dx.doi.org/10.1093/ehjci/jeu105},
volume = {15},
year = {2014}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: Paravalvular leaks (PVL) occur in up to 17% of all surgically implanted prosthetic valves. Re-operation is associated with high morbidity and mortality. Transcatheter closure via a surgical transapical approach (TAp) is an emerging alternative for selected high-risk patients with PVL. The aim of this study was to compare the in-hospital outcomes of patients who underwent surgery and TA-closure for PVL in our single-centre experience. METHODS: From October 2000 to June 2013, 139 patients with PVL were treated in our Institution. All the TA procedures were performed under general anaesthesia in a hybrid operative room: in all but one case an Amplatzer Vascular Plug III device was utilized. RESULTS: Hundred and thirty-nine patients with PVL were treated: 122 patients (87.3%) underwent surgical treatment (68% mitral PVL; 32% aortic PVL) and 17 patients (12.2%) underwent a transcatheter closure via a surgical TAp approach (all the patients had mitral PVL; one case had combined mitral and aortic PVLs); in 35% of surgical patients and in 47% of TAp patients, multiple PVLs were present. The mean age was 62.5 ± 11 years; the Logistic EuroScore was 15.4 ± 3. Most of the patients were in New York Heart Association (NYHA) functional class III-IV (57%). Symptomatic haemolysis was present in 35% of the patients, and it was particularly frequent in the TAp (70%). Many patients had >1 previous cardiac operation (46% overall and 82% of TAp patients were at their second of re-operation). Acute procedural success was 98%. In-hospital mortality was 9.3%; no in-hospital deaths occurred in patients treated through a TAp approach. All the patients had less than moderate residual valve regurgitation after the procedure. Surgical treatment was identified as a risk factor for in-hospital death at univariate analysis (OR: 8, 95% CI: 1.8-13; P = 0.05). Overall actuarial survival at follow-up was 39.8 ± 7% at 12 years and it was reduced in patients who had &g
AU  - Taramasso,M
AU  - Maisano,F
AU  - Latib,A
AU  - Denti,P
AU  - Guidotti,A
AU  - Sticchi,A
AU  - Panoulas,V
AU  - Giustino,G
AU  - Pozzoli,A
AU  - Buzzatti,N
AU  - Cota,L
AU  - De,Bonis M
AU  - Montorfano,M
AU  - Castiglioni,A
AU  - Blasio,A
AU  - La,Canna G
AU  - Colombo,A
AU  - Alfieri,O
DO  - ehjci/jeu105
EP  - 1167
PY  - 2014///
SP  - 1161
TI  - Conventional surgery and transcatheter closure via surgical transapical approach for paravalvular leak repair in high-risk patients: results from a single-centre experience.
T2  - Eur Heart J Cardiovasc Imaging
UR  - http://dx.doi.org/10.1093/ehjci/jeu105
UR  - https://www.ncbi.nlm.nih.gov/pubmed/24866899
VL  - 15
ER  -
Download