title: Closure of a para-valvular aortic leak: with the use of 2 AMPLATZER devices and real-time 2- and 3-dimensional transesophageal echocardiography.
abstract: Paravalvular leaks are well-recognized sequelae of mechanical aortic valve implantation. Clinical manifestations include hemolysis, arrhythmias, and congestive heart failure. Frequently, patients who receive mechanical aortic valves are poor candidates for repeat valve surgery, and the reoperative mortality rate is high. Percutaneous intervention has recently become an alternative to surgery in selected patients. Herein, we describe the percutaneous closure of an aortic paravalvular leak in a 45-year-old man who had undergone 2 aortic valve replacements with mechanical valves. The patient, who was at high surgical risk due to comorbidities, underwent the implantation of 2 AMPLATZER devices with the use of real-time 2- and 3-dimensional transesophageal echocardiography. The early outcome of the procedure was favorable and without sequelae. To our knowledge, this is the 1st report of the closing of an aortic paravalvular leak with the use of 2 closure devices and real-time echocardiographic guidance.
authors.affiliation: Division of Cardiology, Department of Medicine, University of California, San Francisco; San Francisco, California 94143, USA. kurt.hoffmayer@ucsf.edu
authors.forename: Kurt S
authors.initials: KS
authors.lastname: Hoffmayer
authors.forename: Christian
authors.initials: C
authors.lastname: Zellner
authors.forename: Damon M
authors.initials: DM
authors.lastname: Kwan
authors.forename: Suma
authors.initials: S
authors.lastname: Konety
authors.forename: Elyse
authors.initials: E
authors.lastname: Foster
authors.forename: Phillip
authors.initials: P
authors.lastname: Moore
authors.forename: Yerem
authors.initials: Y
authors.lastname: Yeghiazarians
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017023:Coronary Angiography; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D055989:Septal Occluder Device