Repeat surgery has usually been considered the first choice to solve paravalvular leaks of prosthetic valves, but it cames a high operative risk, a high mortality rate and an increased risk for re-leaks. Percutaneous ...Repeat surgery has usually been considered the first choice to solve paravalvular leaks of prosthetic valves, but it cames a high operative risk, a high mortality rate and an increased risk for re-leaks. Percutaneous closure of such defects is possible, and different approaches and devices are used for this purpose. For mitral paravalvular leaks, constructing an arterio-venous wire loop for delivering the closure device through an antegrade approach is the most commonly used technique. Transcatheter closure can also be performed through a transapical approach or retrograde transfemoral arterial approach. We present a case of 68-year-old man with a mitral paravalvular leak that was suc- cessfully closed using an Amplatzer~ Duct Occluder H, via retrograde transfemoral arterial approach under three-dimensional transesophag- eal echocardiographic guidance, without the use of a wire loop. The initial attempt to cross the paravalvular defect was unsuccessful, but the obstacle was finally overcome by introducing complex interventional techniques.展开更多
Percutaneous closure of a prosthetic paravalvular leak （PVL） is a challenging procedure. Operators must use devices constructed for other applications. We present the use of a device which is specifically designed f...Percutaneous closure of a prosthetic paravalvular leak （PVL） is a challenging procedure. Operators must use devices constructed for other applications. We present the use of a device which is specifically designed for PVL closure. To the best of our knowledge, there is no publication in MEDLINE reporting the use of the device.展开更多
BACKGROUND Paravalvular leak(PVL),also known as paravalvular prosthetic regurgitation,is not a rare complication after surgical valve replacement,and it may cause varying degrees of heart failure.The transcatheter clo...BACKGROUND Paravalvular leak(PVL),also known as paravalvular prosthetic regurgitation,is not a rare complication after surgical valve replacement,and it may cause varying degrees of heart failure.The transcatheter closure of PVL is technically demanding and challenging.CASE SUMMARY A 68-year-old man presented with degenerative mitral regurgitation with heart failure,New York Heart Association functional class 3.He received bioprosthetic mitral valve replacement in December 2019.PVL was noted at the location of the aorto-mitral curtain in transesophageal echocardiography without signs of endocarditis or dehiscence of the bioprosthetic valve.Transseptal transcatheter closure of the mitral PVL was performed efficiently using the EchoNavigator virtual marker and Agilis NxT steerable introducer.CONCLUSION This case highlights that the EchoNavigator virtual marker and Agilis NxT steerable introducer can facilitate transseptal transcatheter closure of mitral PVL by reducing the procedure time and contrast media.展开更多
A widely used aortic valve bioprosthesis is susceptible to regurgitation between the sewing ring and the frame of the valve due to its relatively thin fabric coverage. In some cases this leak has been shown to resolve...A widely used aortic valve bioprosthesis is susceptible to regurgitation between the sewing ring and the frame of the valve due to its relatively thin fabric coverage. In some cases this leak has been shown to resolve with administration of protamine, however, tension on this area from annular sutures placed in an asymmetric bicuspid valve annulus may exacerbate the defect.展开更多
文摘Repeat surgery has usually been considered the first choice to solve paravalvular leaks of prosthetic valves, but it cames a high operative risk, a high mortality rate and an increased risk for re-leaks. Percutaneous closure of such defects is possible, and different approaches and devices are used for this purpose. For mitral paravalvular leaks, constructing an arterio-venous wire loop for delivering the closure device through an antegrade approach is the most commonly used technique. Transcatheter closure can also be performed through a transapical approach or retrograde transfemoral arterial approach. We present a case of 68-year-old man with a mitral paravalvular leak that was suc- cessfully closed using an Amplatzer~ Duct Occluder H, via retrograde transfemoral arterial approach under three-dimensional transesophag- eal echocardiographic guidance, without the use of a wire loop. The initial attempt to cross the paravalvular defect was unsuccessful, but the obstacle was finally overcome by introducing complex interventional techniques.
文摘Percutaneous closure of a prosthetic paravalvular leak （PVL） is a challenging procedure. Operators must use devices constructed for other applications. We present the use of a device which is specifically designed for PVL closure. To the best of our knowledge, there is no publication in MEDLINE reporting the use of the device.
文摘BACKGROUND Paravalvular leak(PVL),also known as paravalvular prosthetic regurgitation,is not a rare complication after surgical valve replacement,and it may cause varying degrees of heart failure.The transcatheter closure of PVL is technically demanding and challenging.CASE SUMMARY A 68-year-old man presented with degenerative mitral regurgitation with heart failure,New York Heart Association functional class 3.He received bioprosthetic mitral valve replacement in December 2019.PVL was noted at the location of the aorto-mitral curtain in transesophageal echocardiography without signs of endocarditis or dehiscence of the bioprosthetic valve.Transseptal transcatheter closure of the mitral PVL was performed efficiently using the EchoNavigator virtual marker and Agilis NxT steerable introducer.CONCLUSION This case highlights that the EchoNavigator virtual marker and Agilis NxT steerable introducer can facilitate transseptal transcatheter closure of mitral PVL by reducing the procedure time and contrast media.
文摘A widely used aortic valve bioprosthesis is susceptible to regurgitation between the sewing ring and the frame of the valve due to its relatively thin fabric coverage. In some cases this leak has been shown to resolve with administration of protamine, however, tension on this area from annular sutures placed in an asymmetric bicuspid valve annulus may exacerbate the defect.
