TCT-815 Rates of Paravalvular Leaks Requiring Percutaneous Repair With Plugs After Valve-in-Ring Transcatheter Mitral Valve Replacement, Large Single Center Experience
Recommended Citation
Elewa K, Andrews T, Patel R, Cholagh A, Fram G, Parikh S, Dawdy J, Lee J, Zweig B, Villablanca P, Engel Gonzalez P, O'Neill B, Frisoli T. TCT-815 Rates of Paravalvular Leaks Requiring Percutaneous Repair With Plugs After Valve-in-Ring Transcatheter Mitral Valve Replacement, Large Single Center Experience. J Am Coll Cardiol 2025; 86(17):B353-B354.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Abstract
Background: Transcatheter mitral valve-in-ring (tViR) has been shown to be an effective alternative to re-do surgery for failed annuloplasty repairs. Mitral paravalvular leak (mPVL) is a sequela of mitral repair annuloplasty operations. The incidence of pre-existing concomitant versus new or worse mPVL after tViR is not well known. Methods: This was a single-center retrospective analysis of 58 patients who underwent tViR, between 2017 and 2025, for severe symptomatic MR due to failure of a pre-existing surgical ring. Pre- peri- and post-procedural TEEs were assessed for the presence of pre-existing or worsening mPVL after tViR, as well as management and outcome findings. Results: 12/58 (20%) patients undergoing mitral tViR had moderate or worse mPVL requiring PVL repair after valve deployment. 7 of the 12 (58%) had pre-existing mPVL on baseline TEE, with 2 of 7 having mild PVL that became severe, and 5 of 7 patients having moderate or worse PVL at baseline. 5 of the 12 (42%) patients had no PVL on baseline TEE assessment, with development of new moderate or worse PVL after tViR. All 12 patients underwent successful percutaneous PVL repair with Amplatzer plugs yielding final mild MR or less; 10 had the PVL repair at time of tViR and 2 had it in a staged intervention. Of note, 13/58 (22%) had skirt leak necessitating a second valve. There was no association between PVL repair and 1-yr mortality in this relatively small cohort. Conclusion: In this single center study, we found a higher than previously reported incidence of mPVL requiring percutaneous repair with plugs after mitral tViR (20%). 12% (7/58) of the cohort had pre-existing PVL that worsened or was baseline severe. 8.6% (5/58) of the cohort had new PVL after tViR. Close attention should be paid during mitral tViR procedures for the possibility of baseline mPVL and new or worsening mPVL, and these procedures should ideally be performed by teams capable of performing mPVL repair procedures. Categories: STRUCTURAL: Valvular Disease and Intervention: Mitral
Volume
86
Issue
17
First Page
B353
Last Page
B354
