title: Transcatheter closure of a mechanical perivalvular leak using real-time three-dimensional transesophageal echocardiography guidance.
abstract: A 47-year-old female with symptomatic mitral stenosis from a prior undersized mitral annuloplasty ring underwent mitral valve replacement with a mechanical valve. Later, she developed heart failure from a severe paravalvular leak (PVL). Because of the excessive mortality risks from a possible third open heart procedure, the patient was instead referred for transcatheter PVL closure. Standard fluoroscopy, invasive hemodynamics, and two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography (TEE) imaging were performed during device placement with excellent image quality. The case highlights the unique benefit of 3D TEE imaging for preprocedure sizing, guidance of device deployment intraprocedure, and confirmation of PVL closure.
authors.affiliation: Division of Cardiology, University of California Irvine Medical Center, Irvine, California, USA. nauman.aiza@gmail.com
authors.forename: Nauman
authors.initials: N
authors.lastname: Siddiqi
authors.forename: Arnold
authors.initials: A
authors.lastname: Seto
authors.forename: Pranav M
authors.initials: PM
authors.lastname: Patel
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D055989:Septal Occluder Device; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional