Safety, Efficacy and Long-Term Outcomes of Patients Treated with the Occlutech Paravalvular Leak Device for Significant Paravalvular Regurgitation

Onorato E.M. Alamanni F. Muratori M. Smolka G. Wojakowski W. Pysz P. Zorinas A. Zakarkaite D. Eltchaninoff H. Litzer P.-Y. Godart F. Calvert P. Christou C. Mussayev A. Missiroli B. Buzaev I. Curello S. Tesorio T. Bartorelli A.L.
April-1 2022 MDPI

Journal of Clinical Medicine
2022 #11 Issue 7

Between December 2014 and March 2021, 144 patients with aortic (Ao) or mitral (Mi) paravalvular leaks (PVLs) were enrolled at 21 sites in 10 countries. Safety data were available for 137 patients, who were included in the safety analysis fraction (SAF), 93 patients with Mi PVLs and 44 patients with Ao PVLs. The full analysis set (FAS) comprised 112 patients with available stratum (aortic/mitral leak) as well as baseline (BL), 180-day or later assessments (2 years). Procedural success (implantation of the device with a proper closure of the PVL, defined as reduction in paravalvular regurgitation of ≥one grade as assessed by echocardiography post implantation) was achieved in 91.3% of FAS patients with Mi PVLs and in 90.0% of those with Ao PVLs. The proportion of patients suffering from significant or severe heart failure (HF), classified as New York Heart Association (NYHA) class III/IV, decreased from 80% at baseline to 14.1% at 2-year follow-up (FAS). The proportion of FAS patients needing hemolysis-related blood transfusion decreased from 35.5% to 3.8% and from 8.1% to 0% in Mi patients and Ao patients, respectively. In total, 35 serious adverse events (SAEs) were reported in 27 patients (19.7%) of the SAF population. The SAEs considered possibly or probably related to the device included device embolization (three patients), residual leak (two patients) and vascular complication (one patient). During follow-up, 12/137 (8.8%) patients died, but none of the deaths was considered to be device-related. Patients implanted with the Occlutech Paravalvular Leak Device (PLD) showed long-lasting improvements in clinical parameters, including NYHA class and a reduced dependency on hemolysis-related blood transfusions.

aortic valve , device , hemolysis , long-term outcomes , mitral valve , paravalvular leak , paravalvular regurgitation , transcatheter closure

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Centro Cardiologico Monzino, IRCCS, Milan, 20138, Italy
3rd Division of Cardiology, Medical University of Silesia, Katowice, 40-055, Poland
Department of Cardiovascular Medicine, Vilnius University, Vilnius, 01513, Lithuania
Department of Cardiology and Cardiovascular Surgery, Hospital Charles Nicolle, Rouen, 76000, France
Department of Pediatric Cardiology and Congenital Heart Disease, University of Lille, Lille, 59000, France
Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, CB2 0AY, United Kingdom
American Heart Institute, Nicosia, 1311, Cyprus
National Research Cardiac Surgery Center, Astana, 020000, Kazakhstan
Gemelli Molise di Campobasso-Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Campobasso, 86100, Italy
Cardiovascular Department, Bashkir State Medical University, Ufa, 450008, Russian Federation
USVD Emodinamica, Spedali Civili di Brescia, Brescia, 25123, Italy
Department of Invasive Cardiology, Clinica Montevergine, Mercogliano, 83013, Italy
Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Milan, 20122, Italy

Centro Cardiologico Monzino
3rd Division of Cardiology
Department of Cardiovascular Medicine
Department of Cardiology and Cardiovascular Surgery
Department of Pediatric Cardiology and Congenital Heart Disease
Department of Cardiology
American Heart Institute
National Research Cardiac Surgery Center
Gemelli Molise di Campobasso-Fondazione Policlinico Universitario Agostino Gemelli
Cardiovascular Department
USVD Emodinamica
Department of Invasive Cardiology
Department of Biomedical and Clinical Sciences “Luigi Sacco”

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