Mechanical aortic valve prostheses are considered a limiting factor when contemplating percutaneous closure of mitral paravalvular leaks using a retrograde approach. However, transfemoral artery access and a retrograde approach have advantages over a trans-septal anterograde approach when the paravalvular defect is large with a significant gradient or when the defect is medial to the mitral valve. We describe a novel technique of mitral paravalvular leak closure in the presence of a mechanical aortic valve prosthesis, which we performed successfully in 3 patients. The technique uses a retrograde approach and arteriovenous wire loop.
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