The major indications for treatment of paravalvular leaks include severe symptoms with valve regurgitation and persistent, severe hemolysis requiring multiple periodic blood transfusions. The current gold standard for treatment of paravalvular leaks is surgery with either replacement or resuturing of the original prosthesis. Reoperation is associated with higher mortality and morbidity than the initial operation, with reported mortality as high as 13%, 15% and 37% following first, second and third procedures, respectively.4 The operative mortality after paravalvular leak surgery is around 7%, and the perioperative stroke rate of 5% with a 10-year Kaplan.Meier survival of 30%. In elderly patients with comorbidities, and in patients with multiple prior chest surgeries, however, the risks of reoperation frequently prohibit surgery. In these patients, percutaneous closure offers an attractive alternative for the treatment of paravalvular leaks, as it is considerably less invasive than surgery and might be associated with fewer risks to the patient.5–7

" /> The major indications for treatment of paravalvular leaks include severe symptoms with valve regurgitation and persistent, severe hemolysis requiring multiple periodic blood transfusions. The current gold standard for treatment of paravalvular leaks is surgery with either replacement or resuturing of the original prosthesis. Reoperation is associated with higher mortality and morbidity than the initial operation, with reported mortality as high as 13%, 15% and 37% following first, second and third procedures, respectively.4 The operative mortality after paravalvular leak surgery is around 7%, and the perioperative stroke rate of 5% with a 10-year Kaplan.Meier survival of 30%. In elderly patients with comorbidities, and in patients with multiple prior chest surgeries, however, the risks of reoperation frequently prohibit surgery. In these patients, percutaneous closure offers an attractive alternative for the treatment of paravalvular leaks, as it is considerably less invasive than surgery and might be associated with fewer risks to the patient.5–7

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Methodist Journal

IN THIS ISSUE

Nutritional Supplements and the Heart

Vol 15, Issue 3 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

Dietary Supplements: Facts and Fallacies

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RECOGNITIONS

Drs. Raizner and Cooke Take the Lead in Special Issue on Supplements

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REVIEW ARTICLES See More

Recent Clinical Trials Shed New Light on the Cardiovascular Benefits of Omega-3 Fatty Acids

Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment

Coenzyme Q10

Red Yeast Rice for Hypercholesterolemia

Inorganic Nitrate Supplementation for Cardiovascular Health

Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk?

Cardiovascular Risk of Proton Pump Inhibitors

Advanced Cardiac Imaging for Complex Adult Congenital Heart Diseases

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Snoopy’s Heart: A Case of Complete Congenital Absence of the Pericardium

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

POINTS TO REMEMBER

The Kidney in Congenital Cyanotic Heart Disease

EXCERPTA

Talking Statins with Antonio Gotto

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”