Paravalvular leak closure after TAVI with plugs: A literature review with a specific focus on arterio-arterial loop

Catheter Cardiovasc Interv. 2024 Sep;104(3):614-620. doi: 10.1002/ccd.31145. Epub 2024 Jul 10.

Abstract

More than mild paravalvular leak (PVL) following transcatheter aortic valve implantation (TAVI) is associated with a twofold increase in all-cause mortality, heart failure hospitalizations, and the need for reintervention. Successfully addressing PVL in TAVIs is more challenging than in surgical valves. The arterial-arterial (A-A) rail technique emerges as a valuable strategy for post-TAVI PVL closure, enhancing success rates by enabling the effective use of lower-profile vascular plug devices. When standard approach is ineffective, generating an A-A loop for post-TAVI PVL closure is probably the most recommended strategy to ensure procedural success.

Keywords: arterial‐arterial rail technique; paravalvular leakage; transcatheter aortic valve implantations.

Publication types

  • Review

MeSH terms

  • Aortic Valve Insufficiency / diagnostic imaging
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / mortality
  • Aortic Valve Insufficiency / surgery
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery
  • Aortic Valve* / diagnostic imaging
  • Aortic Valve* / physiopathology
  • Aortic Valve* / surgery
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation
  • Heart Valve Prosthesis*
  • Humans
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Transcatheter Aortic Valve Replacement* / instrumentation
  • Treatment Outcome