title: Multimodality image guidance with Dyna-CT for transcatheter treatment of paravalvular leak of a stentless valve.
abstract: The transcatheter treatment of paravalvular leaks (PVL) are technically challenging procedures; they pose increasing difficulty in cases where there is a stentless valve, without the usual fluoroscopic landmarks. Hence, there is limited experience in treating this defect percutaneously. We present a case of a patient with an aortic PVL of a stentless valve and how the integrated use of multi-imaging modalities (transesophageal echocardiography, computed tomography and rotational angiography) allowed the demarcation of landmarks onto live fluoroscopy and guided the transcatheter occlusion of the PVL.
authors.affiliation: Cardiology and Interventional Cardiology, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Brett
authors.initials: B
authors.lastname: Van Leer-Greenberg
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Martinez
authors.forename: Alan W
authors.initials: AW
authors.lastname: Heldman
mesh_terms: D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000000981:diagnostic imaging / Q000628:therapy*; D001705:Bioprosthesis; D006328:Cardiac Catheterization; D004452:Echocardiography / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D011475:Prosthesis Failure; D019233:Retreatment / Q000379:methods; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
keywords: CT/multidetector CT; IAF-Imaging; ICT-imaging; ITTE-imaging; TTE/TEE; angiographic/fluoroscopic; aortic valve disease; electron beam; paravalvular leak; percutaneous intervention