Closure of a percutaneous tricuspid paravalvular leak with the Amplatzer Muscular VSD device

• Published in: REC, Interventional cardiology (Internet. English ed.) Interventional cardiology (Internet. English ed.), 2024-07, Vol.6 (2), p.144-146
• Main Authors: Guillén Mendoza, Noelia B., Abelleira Pardeiro, César, Balbacid Domingo, Enrique J., Galiano, and, Ángela Uceda, Gutiérrez-Larraya Aguado, Federico
• Format: Article
• Language: English
• ISSN: 2604-7322; 2604-7322
• DOI: 10.24875/RECICE.M23000411

We present the case of a 16-year-old girl with a prenatal diagnosis of Ebstein's anomaly and an atrial septal defect with severe tricuspid regurgitation. In 2020, the patient was referred due to functional deterioration. Surgical repair included the implantation of a 26-mm Contour 3D tricuspid annuloplasty ring (Medtronic, United States) with the cone reconstruction technique and closure of the atrial septal defect. During the postoperative follow-up, the patient developed moderate paravalvular leak lateral to the ring that progressed to severe regurgitation with moderate right ventricular dilatation without dysfunction a year and a half later. The patient experienced no episodes of heart failure until 2 years after surgery. Cardiac catheterization was performed via transjugular and right femoral access under general anesthesia and transesophageal echocardiography guidance, revealing the presence of a 13 mm × 10 mm leak posterolateral to the tricuspid annuloplasty ring that appeared as a 15 mm leak on ventriculography (figure 1). The first closure attempt with a 14-mm Konar MF device (Lifetech, China) did not achieve complete closure or attachment at the defect. Therefore, a second attempt was made with an 18-mm Amplatzer Muscular VSD device (Abbott, United States), which achieved proper attachment and almost complete occlusion (figure 2). After release,...