Percutaneous transcatheter closure of paravalvular leaks is an attractive treatment option in high risk symptomatic patients unsuitable for redo surgery. We present a case of a 64 year-old woman with double mechanical mitral and aortic valve prosthesis referred for a symptomatic mitral paravalvular leak. Because of the high surgical risk transcatheter closure of the defect was planned. The procedure was performed under real time 3D transoesophageal echocardiographic guidance via trans-septal approach. An Amplatzer Vascular Plug III 14 × 3 mm was implanted using an arteriovenous wire loop established through the aortic valve prosthesis. A transient dysfunction of the mitral prosthesis occurred, but it resolved spontaneously within few hours. Transcatheter paravalvular leak closure with an arteriovenous wire loop across a mechanical aortic valve prosthesis has never been described. We discuss the main technical issues.
Copyright © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.