title: Closure of apical access site after transapical, transcatheter paravalvular leak closure.
abstract: The safety of percutaneous transapical mitral paravalvular leak (PVL) closure could potentially be enhanced by device closure of the ventricular access site. Percutaneous transapical PVL closure was performed. The 9F delivery sheath was pulled back, and a 6-mm Amplatzer muscular ventricular septal defect occluder was deployed at the apical puncture site. Immediate hemostasis was achieved. Total hospitalization was 9 days. New York Heart Association functional class was improved, hemoglobin and haptoglobin rose, while lactate dehydrogenase fell. Follow-up fluoroscopy and transthoracic echocardiography revealed a good functional result. Closure of the apical access site by means of an Amplatzer muscular ventricular septal defect occluder is feasible.
authors.affiliation: Department of Cardiology, University Hospital Basel, Basel, Switzerland. fabian.nietlispach@insel.ch
authors.forename: Fabian
authors.initials: F
authors.lastname: Nietlispach
authors.forename: Friedrich
authors.initials: F
authors.lastname: Eckstein
authors.forename: Manfred
authors.initials: M
authors.lastname: Seeberger
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
authors.forename: Beat A
authors.initials: BA
authors.lastname: Kaufmann
authors.forename: Oliver
authors.initials: O
authors.lastname: Reuthebuch
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D055989:Septal Occluder Device