title: Two-stage percutaneous closure of paravalvular leak in a patient with stentless aortic bioprosthesis.
abstract: We report a case of successful 2-stage percutaneous closure of severe paravalvular leak (PVL) in a patient with stentless aortic bioprosthesis. Threat of pliable prosthesis compression and long course of PVL posed main considerations. Accordingly, Amplatzer vascular plug (AVP) 2 was chosen as occluder. It was delivered transfemorally under fluoroscopy and transesophageal echocardiography guidance. No prosthesis distortion was provoked at the expense of moderate residual leak. Its symptoms after 3 months spurred another AVP 2 implantation, which lead to PVL closure with no effect on valve area. Marked reduction of left ventricle cavity size and NT-proBNP plasma concentration was promptly noted and remains stable in 12-month follow-up.
authors.affiliation: Department of Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Smolka
authors.forename: Piotr
authors.initials: P
authors.lastname: Pysz
authors.forename: Marek
authors.initials: M
authors.lastname: Jasinski
mesh_terms: D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography; D015415:Biomarkers / Q000097:blood; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000295:instrumentation; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015641:Radiography, Interventional; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain