title: Percutaneous transcatheter closure of mitral paravalvular leak via transarterial retrograde approach.
abstract: Repeat surgery has usually been considered the first choice to solve paravalvular leaks of prosthetic valves, but it carries a high operative risk, a high mortality rate and an increased risk for re-leaks. Percutaneous closure of such defects is possible, and different approaches and devices are used for this purpose. For mitral paravalvular leaks, constructing an arterio-venous wire loop for delivering the closure device through an antegrade approach is the most commonly used technique. Transcatheter closure can also be performed through a transapical approach or retrograde transfemoral arterial approach. We present a case of 68-year-old man with a mitral paravalvular leak that was successfully closed using an Amplatzer(®) Duct Occluder II, via retrograde transfemoral arterial approach under three-dimensional transesophageal echocardiographic guidance, without the use of a wire loop. The initial attempt to cross the paravalvular defect was unsuccessful, but the obstacle was finally overcome by introducing complex interventional techniques.
authors.affiliation: Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, China.
authors.forename: Ho-Ping
authors.initials: HP
authors.lastname: Yu
authors.affiliation: Division of Cardiology, Cathay General Hospital, Taipei, Taiwan, China.
authors.forename: Chi-Hung
authors.initials: CH
authors.lastname: Huang
authors.affiliation: Division of Cardiac Surgery, Cathay General Hospital, Taipei, Taiwan, China.
authors.forename: Shaw-Min
authors.initials: SM
authors.lastname: Hou
authors.affiliation: Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, China.
authors.forename: Ming-Chon
authors.initials: MC
authors.lastname: Hsiung
authors.affiliation: Department of Anesthesiology, Cheng-Hsin General Hospital, Taipei, Taiwan, China.
authors.forename: Shen-Kou
authors.initials: SK
authors.lastname: Tsai
authors.affiliation: Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, China; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan, China.
authors.forename: Wei-Hsian
authors.initials: WH
authors.lastname: Yin
keywords: Antegrade approach; Paravalvular leaks; Prosthetic valve; Retrograde approach; Wire loop