Two‐step approach of percutaneous closure of a paravalvular leak and atrial septal defect after mitral valve reoperation

Severe paravalvular leakage following mitral valve replacement, a rare but potentially serious complication, may result in heart failure and significant hemolysis. Reoperation is considered standard of care. However, in selected patients, re‐do sternotomy carries excessively high surgical risk. Perc...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2011-07, Vol.78 (1), p.145-150, Article 145
Main Authors: Sriratanaviriyakul, Narin, Hart, Chari, Spies, Christian
Format: Article
Language:English
Subjects:
Adult
atrial septal defect
Atrial Septum - injuries
Cardiac Catheterization - instrumentation
case report
Echocardiography, Doppler, Color
Echocardiography, Transesophageal
endovascular therapy
Fluoroscopy
Heart Injuries - diagnostic imaging
Heart Injuries - etiology
Heart Injuries - therapy
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - instrumentation
Humans
Male
Mitral Valve - diagnostic imaging
Mitral Valve - surgery
Prosthesis Design
Prosthesis Failure
Radiography, Interventional
Septal Occluder Device
transeptal catheterization
Treatment Outcome
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Summary:Severe paravalvular leakage following mitral valve replacement, a rare but potentially serious complication, may result in heart failure and significant hemolysis. Reoperation is considered standard of care. However, in selected patients, re‐do sternotomy carries excessively high surgical risk. Percutaneous closure of paravalvular leaks has become a viable option for these patients. We present a case of a highly symptomatic 42‐year‐old male who underwent successful percutaneous closure of two paravalvular leaks and a post‐operative atrial septal defect after re‐do mitral valve replacement surgery. As access to the left atrium was expected to be difficult following percutaneous atrial septal defect closure, a two‐step approach of paravalvular leak closure followed by atrial septal defect closure was chosen. Difficulties of atrial septal defect closure following closure of a paravalvular leak next to the inter‐atrial septum will be discussed. © 2011 Wiley‐Liss, Inc.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.22855