New rechristened rectangular Amplatzer PVL plug for transcatheter closure

In a recent study published in IHJ researchers tried a Single-center experience of transcatheter closure of mitral and aortic Paravalvular leaks using the new rechristened rectangular Amplatzer PVL plug.

Among 79 transcatheter PVL closures in 8 years, 16 patients received Amplatzer PVL plug. Crescentic shape on three-dimensional echocardiogram was the inclusion criterion. Exclusion criteria was (i) long-axis dimension of PVL exceeding 12 mm; (ii) non-availability of appropriate sized plug in shelf.

In crescentic leaks, Amplatzer PVL plug varying from 8-4 mm to 14-5 mm was preferred. The plug was chosen 1.2–2 times larger than the PVL and the device auto-oriented to the leak. The small 2 mm rim avoided mechanical interference.

Data collection included symptom class, cardiac rhythm, surgical details, type of prosthesis, ventricular ejection fraction, grade of pulmonary hypertension, blood tests for hemolysis and renal function. Residual PVL and valve function were evaluated on echocardiography on 1,6 and 12-month follow-up.

Sixteen patients aged 18–78 years, who received a total of 18 AVP III devices formed the study cohort 8 plugs were implanted in aortic and 10 plugs in mitral position. Two patients received two adjacent Amplatzer PVL plugs in mitral position.

Based on the analysis of the results the research team concluded that the oblong-shaped Amplatzer PVL plug provided successful closure in crescentic mitral and aortic PVL.

According to the authors the study adds that a rectangular recently rechristened Amplatzer PVL plug adds to the armamentarium for crescentic leaks along the circumference. Auto-orientation of the plug and minimal protrusion are hence favorable attributes.

Reference:

Pramod Sagar, Sreeja Pavithran, Monica Rajendran, Kothandam Sivakumar, Single-center experience of transcatheter closure of mitral and aortic Paravalvular leaks using the new rechristened rectangular Amplatzer PVL plug, Indian Heart Journal, Volume 74, Issue 3,2022, Pages 239-241, ISSN 0019-4832,https://doi.org/10.1016/j.ihj.2022.04.004.