title: Late embolization of a vascular plug III device after mitral paravalvular leak closure.
abstract: We present a case report of an 80-year-old frail woman with hemolytic anemia and cardiac failure secondary to mitral severe paravalvular regurgitation. Her clinical history was significant for mitral valve replacement that was complicated with a paravalvular leak two months after surgery. The leak was closed percutaneously with an Amplatzer Vascular Plug III single device. A year later she is readmitted with heart failure and the transesophageal echocardiogram revealed a severe paravalvular leak beside the Vascular Plug III device that seemed to be dislodged and rocking. During a new attempt of percutaneous leak closure, while trying to lasso the old device, it embolized to the iliac bifurcation. The old device could be removed from the right femoral artery and the leak could be closed with two new Vascular Plug III devices deployed simultaneously. To our knowledge this is the first reported case of a late embolization of a Vascular Plug III device.
authors.affiliation: Cardiology Division, Department of Medicine, Hospital de Sant Pau I de la Santa Creu, Universidad de Barcelona, Barcelona, Spain.
authors.forename: Dabit
authors.initials: D
authors.lastname: Arzamendi
authors.forename: Chi Hion
authors.initials: CH
authors.lastname: Li
authors.forename: Antoni
authors.initials: A
authors.lastname: Serra
mesh_terms: D000369:Aged, 80 and over; D000743:Anemia, Hemolytic / Q000175:diagnosis / Q000209:etiology; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D020878:Device Removal; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004867:Equipment Design; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016330:Frail Elderly; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: angiography; complications adult cath/intervention; congestive heart failure; quantitative coronary