title: Transcatheter closure through transapical access for mitral paravalvular leak after previous trans-septal mitral operation.
abstract: Because paravalvular leak after mitral valve replacement in highly morbid patients is a troublesome issue, there has been a growing interest in less invasive procedures. We conducted transcatheter paravalvular leak closure of a mitral valve prosthesis through left ventricular apical access. The patient had undergone redo mitral valve replacement through a transatrial septal approach 2 months prior to the procedure; thus, penetration of the atrial septum was considered to be difficult through the ordinary antegrade trans-septal approach. Transapical access for the mitral paravalvular leak was conducted using two AMPLATZER Vascular Plugs (St. Jude Medical, St. Paul, MN), with a route directed straight to the defect. This approach is an alternative technique for transcatheter paravalvular leak closure. This is the first case report of transapical access for transcatheter paravalvular leak closure in Japan.
authors.affiliation: Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan. takashimurakami24@hotmail.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Suehiro
authors.affiliation: Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nishimura
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugioka
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Iwata
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Asahiro
authors.initials: A
authors.lastname: Ito
authors.affiliation: Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Etsuji
authors.initials: E
authors.lastname: Sohgawa
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Mizutani
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.affiliation: Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shibata
mesh_terms: D000368:Aged; D054087:Atrial Septum / Q000000981:diagnostic imaging / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D017548:Echocardiography, Transesophageal; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation
keywords: Paravalvular leak; Trans-septal approach; Transcatheter closure