Closing Mitral Paravalvular Leak: Comparing Catheter-based Transapical Option against Surgical Treatment Option

Abstract

Purpose: The goal of this study was to compare the closure of catheter-based transapical option against surgical treatment option for mitral paravalvular leak. 
 Methodology: The study employed a retrospective observational study design to compare closure of mitral paravalvular leak using catheter-based transapical option and surgical treatment option. The study had a sample size of 76 patients who were grouped into surgical group or catheter group. The surgical group was allocated 49 patients after re-do surgery while the catheter group was allocated 27 patients after transapical catheter–based treatment.
 Findings: According to the study’s result, in-hospital myocardial necrosis occurred in 9 (18%) cases in the surgical group and none in the catheter group, p = 0.018. Procedure-related life-threatening bleeding occurred in 9 (18%) patients in the surgical group and none in the catheter group, p = 0.018. Nine (18%) patients died in 30 days in the surgical group, and none died in the catheter group, p = 0.039. A mean follow-up was 3.3 years. No difference was found between the groups by the degree of residual paravalvular regurgitation either at discharge or at follow-up. During the follow-up, 19 (39%) patients died in the surgical group and 2 (7%) among the catheter patients.
 Conclusion: Transapical catheter-based closure of mitral paravalvular leak seems to be a safer treatment procedure than conventional re-do surgery, and the effectiveness of these procedures does not differ.