title: Transcatheter Simultaneous Double-Transapical Access for Paravalvular Mitral Leak Closure Using the Occlutech PLD.
abstract: A 67-year-old patient with rheumatic heart valve disease had undergone two cardiac surgeries at the age of 30 years, then re-do with mitral valve replacement at 50 years. She presented with congestive heart failure and hemolytic anemia. Doppler echocardiography showed moderate-severe mitral regurgitation due to paravalvular mitral valve leak (PVML) and severe pulmonary hypertension. Transesophageal echocardiography demonstrated severe PVML secondary to a large 20 mm-long PVML defect. Due to comorbidities, the heart team deemed a third reoperation at very high surgical risk; therefore, the patient was considered most suitable for a transcatheter approach to PVML closure. Two Occlutech paravalvular leak devices were successfully delivered using a simultaneous double-transapical access with double-wire technique.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pestrichella
authors.forename: Antonio
authors.initials: A
authors.lastname: Pignatelli
authors.forename: Rossella
authors.initials: R
authors.lastname: Alemanni
authors.forename: Rosamaria
authors.initials: R
authors.lastname: Montesanti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Braccio
authors.forename: Francesco
authors.initials: F
authors.lastname: Greco
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: D'Ambruoso
authors.forename: Cataldo Davide
authors.initials: CD
authors.lastname: Memmola
authors.forename: Mauro
authors.initials: M
authors.lastname: Cassese
authors.forename: Gaetano
authors.initials: G
authors.lastname: Contegiacomo
authors.affiliation: Division of Cardiology, London Health Sciences Centre, Department of Medicine, Western University, 339 Windermere Rd, University Hospital, London, Ontario, Canada, N6A 5A5. rodrigo.bagur@lhsc.on.ca.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Bagur
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D011475:Prosthesis Failure; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D012214:Rheumatic Heart Disease / Q000150:complications*; D055989:Septal Occluder Device; D016896:Treatment Outcome