title: Transapical closure of paraprosthetic mitral leak in a patient with inferior vena cava interruption and azygos continuation.
abstract: Para-valvular leaks represent a relevant post-operative complication of cardiac valve replacement, often causing heart failure or severe hemolysis. We report a case of a 72 year-old woman with aortic and mitral mechanical prostheses who developed hemolytic anemia because of a para-prosthetic mitral leak. Chest tomography in such patient unexpectedly documented inferior vena cava interruption with azygos continuation into superior vena cava. Given the high surgical risk, the venous anomaly and the presence of the aortic valve prosthesis, transcatheter leak closure via antero-lateral mini-thoracotomy and transapical approach was performed.
authors.affiliation: aCampus Bio-Medico University of Rome bPoliclinico San Donato Milanese, Milan, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Mega
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Patti
authors.forename: Mario
authors.initials: M
authors.lastname: Carminati
authors.forename: Pietro
authors.initials: P
authors.lastname: Sedati
authors.forename: Andrea
authors.initials: A
authors.lastname: D'Ambrosio
authors.forename: Germano
authors.initials: G
authors.lastname: Di Sciascio
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001401:Azygos Vein; D006328:Cardiac Catheterization / Q000379:methods*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D014682:Vena Cava, Inferior