title: The challenge of integrated echocardiographic approach in percutaneous closure of paravalvular leak.
abstract: Paravalvular leak after prosthetic mitral valve surgery may lead to symptomatic mitral regurgitation and hemolytic anemia requiring reoperation. Percutaneous closure of paravalvular leaks is a relatively recent technique still considered a challenging procedure burdened by possible complications, to be offered only to poor redo surgical candidate patients. Multimodality imaging is advocated to plan and guide the procedure, to minimize the risk of complications. We report on a case of dehisced prosthetic mitral valve in which transthoracic real time three-dimensional echocardiography was used to locate the dehiscence area and characterize mitral paraprosthesis leak, whereas intracardiac echocardiography was used to guide and monitor the percutaneous closure procedure.
authors.affiliation: Heart and Vessels Department, AOU Careggi, Florence, Italy. cappellifrancesco@inwind.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Cappelli
authors.forename: Maria Riccarda
authors.initials: MR
authors.lastname: Del Bene
authors.forename: Gennaro
authors.initials: G
authors.lastname: Santoro
authors.forename: Francesco
authors.initials: F
authors.lastname: Meucci
authors.forename: Paola
authors.initials: P
authors.lastname: Attanà
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barletta
mesh_terms: D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D057867:Endoleak / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D018084:Ultrasonography, Interventional