Percutaneous closure of paravalvular leaks
Summary
Percutaneous closure of paravalvular leak (PVL) is a complex procedure that requires multiple imaging modalities to visualise the three-dimensional relationship of intracardiac structures and the operator’s ability to navigate within 3-dimensional space. Three approaches can be employed in order to cross the defect and deliver the closure device: transseptal, retrograde transaortic, and direct transapical. Despite the big variety of available devices, there are no dedicated devices for paravalvular leak closure. Results of percutaneous closure appear to be superior to surgical outcomes with lower complication rates and higher success rates.
Introduction
Paravalvular leak (PVL) is a regurgitant jet that originates between the outer margin of the prosthetic ring and the native tissues around the valve. It is a well-known complication of valve replacement and has been found to occur in as many as 10% of prosthetic valves in the aortic position 1 and 17% of prosthetic valves in the mitral position 1
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