Paravalvular Regurgitation: an Overview of Indications for Closure and Management Strategies

Purpose of review: Paravalvular leak (PVL) after surgical or transcatheter valve replacement is common, occurring in up to one-third of patients. As a method to avoid open surgery, transcatheter closure of PVL has become an established therapy in selected cases.

Recent findings: To facilitate procedural success, baseline comprehensive assessment by echocardiography and cardiac computed tomography (CCT), intraprocedural guidance by echocardiography and fluorography, and appropriate wire rail techniques are essential. We present examples of how to treat challenging PVL cases in the aortic and mitral positions. Although challenging, transcatheter PVL repair is effective and safe for treatment of PVL in selected cases by experienced operators.