title: Mitral valve replacement complicated by iatrogenic left ventricular outflow obstruction and paravalvular leak: case report and review of literature.
abstract: BACKGROUND
  Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement.
  
  
  METHODS
  We present a case that displays the unique therapeutic challenges of treating a patient who developed both LVOT obstruction and mitral PVL after undergoing surgical aortic and mitral valve replacement (MVR). We also describe the use of alcohol septal ablation and albumin-glutaraldehyde (BioGlue) for septal ablation to percutaneously treat the patient's LVOT obstruction, followed by use of an Amplatzer vascular plug for percutaneous closure of an antero-medial mitral PVL associated with severe regurgitation.
  
  
  CONCLUSIONS
  Percutaneous interventional management of these entities may be considered as an initial therapeutic option, especially in high-risk patients with significant morbidity and mortality of repeat surgical operations.
authors.affiliation: Department of Internal Medicine, University of Arizona, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ, 85724-5040, USA. justin88LEE@gmail.com.
authors.forename: Justin Z
authors.initials: JZ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, University of Arizona, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ, 85724-5040, USA. kairou.tey@gmail.com.
authors.forename: Kai R
authors.initials: KR
authors.lastname: Tey
authors.affiliation: Department of Cardiovascular Diseases, University of Arizona, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ, 85724-5040, USA. amizyed@yahoo.com.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Mizyed
authors.affiliation: Department of Radiology, University of Arizona, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ, 85724-5040, USA. hennemeyer@mac.com.
authors.forename: Charles T
authors.initials: CT
authors.lastname: Hennemeyer
authors.affiliation: Department of Cardiovascular Diseases, University of Arizona, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ, 85724-5040, USA. raj@shc.arizona.edu.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Janardhanan
authors.affiliation: Department of Cardiovascular Diseases, University of Arizona, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ, 85724-5040, USA. klotun@shc.arizona.edu.
authors.forename: Kapildeo
authors.initials: K
authors.lastname: Lotun
mesh_terms: D055011:Ablation Techniques; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011475:Prosthesis Failure / Q000209:etiology*; D011506:Proteins / Q000627:therapeutic use; D055989:Septal Occluder Device; D014694:Ventricular Outflow Obstruction / Q000209:etiology* / Q000601:surgery
chemical_list: C472676:Bio-glue; D011506:Proteins