TY - JOUR
T1 - Multimodality imaging guidance for percutaneous paravalvular leak closure
T2 - Insights from the multi-centre FFPP register
AU - Hascoet, Sébastien
AU - Smolka, Grzegorz
AU - Bagate, Francois
AU - Guihaire, Julien
AU - Potier, Agathe
AU - Hadeed, Khaled
AU - Lavie-Badie, Yoan
AU - Bouvaist, Hélène
AU - Dauphin, Claire
AU - Bauer, Fabrice
AU - Nejjari, Mohammed
AU - Pillière, Remy
AU - Brochet, Eric
AU - Mangin, Lionel
AU - Bonnet, Guillaume
AU - Ciobotaru, Vlad
AU - Leurent, Guillaume
AU - Hammoudi, Najib
AU - Aminian, Adel
AU - Karsenty, Clement
AU - Spaulding, Christian
AU - Armero, Sebastien
AU - Collet, Frederic
AU - Champagnac, Didier
AU - Ternacle, Julien
AU - Kloeckner, Martin
AU - Gerardin, Benoit
AU - Isorni, Marc Antoine
N1 - Publisher Copyright:
© 2018 Elsevier Masson SAS
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background: Percutaneous paravalvular leak (PVL) closure has emerged as a palliative alternative to surgical management in selected high-risk patients. Percutaneous procedures are challenging, especially for mitral PVL. Accurate imaging of the morphologies of the defects is mandatory, together with precise guidance in the catheterization laboratory to enhance success rates. Aims: To describe imaging modalities used in clinical practice to guide percutaneous PVL closure and assess the potential of new imaging tools. Methods: Data from the ‘Fermeture de Fuite paraprothétique’ (FFPP) register were used. The FFPP register is an international multi-institutional collaborative register started in 2017 with a retrospective and a prospective part. A descriptive analysis of multimodality imaging used to guide PVL closure in clinical practice was performed. Results: Data from 173 procedures performed in 19 centres from three countries (France, Belgium and Poland) were collected, which included eight cases of PVL following transcatheter valve replacement. Transoesophageal echocardiography was used in 167 cases (96.5%) and 3D echocardiography in 87.4% of cases. In one case, 3D-echocardiography was fused with fluoroscopy images in real time using echonavigator software. Details about multimodality imaging were available from a sample of 31 patients. Cardiac computed tomography (CT) was performed before 10 of the procedures. In one case, fusion between preprocedural cardiac CT angiography data and fluoroscopy data was used. In two cases, a 3D model of the valve with PVL was printed. Conclusion: Echocardiography, particularly the 3D mode, is the cornerstone of PVL imaging. Other imaging modalities, such as cardiac CT and cardiac magnetic resonance imaging, may be of complementary interest. New techniques such as imaging fusion and printing may further facilitate the percutaneous approach of PVLs.
AB - Background: Percutaneous paravalvular leak (PVL) closure has emerged as a palliative alternative to surgical management in selected high-risk patients. Percutaneous procedures are challenging, especially for mitral PVL. Accurate imaging of the morphologies of the defects is mandatory, together with precise guidance in the catheterization laboratory to enhance success rates. Aims: To describe imaging modalities used in clinical practice to guide percutaneous PVL closure and assess the potential of new imaging tools. Methods: Data from the ‘Fermeture de Fuite paraprothétique’ (FFPP) register were used. The FFPP register is an international multi-institutional collaborative register started in 2017 with a retrospective and a prospective part. A descriptive analysis of multimodality imaging used to guide PVL closure in clinical practice was performed. Results: Data from 173 procedures performed in 19 centres from three countries (France, Belgium and Poland) were collected, which included eight cases of PVL following transcatheter valve replacement. Transoesophageal echocardiography was used in 167 cases (96.5%) and 3D echocardiography in 87.4% of cases. In one case, 3D-echocardiography was fused with fluoroscopy images in real time using echonavigator software. Details about multimodality imaging were available from a sample of 31 patients. Cardiac computed tomography (CT) was performed before 10 of the procedures. In one case, fusion between preprocedural cardiac CT angiography data and fluoroscopy data was used. In two cases, a 3D model of the valve with PVL was printed. Conclusion: Echocardiography, particularly the 3D mode, is the cornerstone of PVL imaging. Other imaging modalities, such as cardiac CT and cardiac magnetic resonance imaging, may be of complementary interest. New techniques such as imaging fusion and printing may further facilitate the percutaneous approach of PVLs.
KW - 3D echocardiography
KW - 4D-flow MRI
KW - Cardiac valve
KW - Echocardiographie 3D
KW - Fuite paraprothétique
KW - IRM 4D flow
KW - Paravalvular leak
KW - Valve cardiaque
UR - http://www.scopus.com/inward/record.url?scp=85048895813&partnerID=8YFLogxK
U2 - 10.1016/j.acvd.2018.05.001
DO - 10.1016/j.acvd.2018.05.001
M3 - Article
C2 - 29937207
AN - SCOPUS:85048895813
SN - 1875-2136
VL - 111
SP - 421
EP - 431
JO - Archives of Cardiovascular Diseases
JF - Archives of Cardiovascular Diseases
IS - 6-7
ER -