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Percutaneous closure of mitral paravalvular leak guided by three-dimensional transesophageal echocardiography

Reoperation is the method of choice for correction of prosthetic paravalvular leaks. The percutaneous repair of mitral paravalvular leaks might represent an interesting alternative for selected cases. We report two cases of mitral paravalvular leaks treated with AmplatzerTM Vascular Plug III guided by three-dimensional transesophageal echocardiography using the percutaneous approach. The first case was of a 55-year old male who had undergone five previous cardiac surgeries (aortic and mitral valve replacements) and evolved with New York Heart Association (NYHA) class III heart failure and severe mitral regurgitation. The second case was of a 76-year old male previously submitted to aortic valve replacement twice, the last one associated to mitral valve replacement, which evolved with NYHA class IV heart failure and severe mitral regurgitation, and had several comorbidities increasing surgical risk. The procedures were performed percutaneously under general anesthesia using the transeptal approach to deploy the plugs, which occluded the paravalvular defects successfully in both cases.

Mitral valve; Heart valve prosthesis; Heart valve prosthesis implantation Echocardiography, transesophageal; Echocardiography, three-dimensional


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