NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
ID number 1786
Description The procedure is done using a combination of local anaesthetic and sedation, or general anaesthesia. The exact technique varies according to the type of leak being repaired. For mitral valves, an antegrade transseptal approach is most commonly used. In this approach, transseptal left atrial catheterisation is done under imaging guidance using standard techniques. A guidewire may be used to cross the leak. A delivery sheath is then passed from the venous access and 1 or more closure devices are deployed to close the leak. Transoesophageal echocardiography is used to confirm adequate reduction of peri-mitral regurgitation and fluoroscopy used to confirm normal mechanical prosthetic leaflet motion before closure device release. For aortic valves, a retrograde approach is usually used. Transthoracic echocardiography may be adequate to image the leak, but for posterior leaks, transoesophageal echocardiography or intracardiac echocardiography may be needed. The leak is usually crossed using a guidewire over a catheter. After crossing, the guidewire is exchanged for a stiffer wire and a delivery sheath is advanced to deploy the closure device. One device is usually enough to close aortic paravalvular leaks.

Provisional Schedule

Expected publication 23 June 2021

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Timeline

Key events during the development of the guidance:

Date Update
28 January 2021 - 25 February 2021 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance