Evaluation of Paravalvular Leaks through Color Doppler Three-Dimensional Transesophageal Echocardiography

Correction of extensive mitral paravalvular leak with three occlusion devices via transapical access: a case report

“…9 Success in PVL treatment depends on a collaborative work by the echocardiographer and the interventionist to precisely determine the dimensions of the PVL and to locate its regurgitation site. 2,6 The aid of three-dimensional TEE allows a better evaluation of the characteristics of the cardiac defect and the actions during the procedure. 2 This technique was of paramount importance in the present report, since it helped positioning the three occlusive devices and adjusting them to the PVL shape.…”

“…2,6 The aid of three-dimensional TEE allows a better evaluation of the characteristics of the cardiac defect and the actions during the procedure. 2 This technique was of paramount importance in the present report, since it helped positioning the three occlusive devices and adjusting them to the PVL shape.…”

“…7 This structural diversity, besides increasing the technical complexity of the procedure, renders a complete PVL occlu sion difficult to be achieved. 2,6 For this reason, the development of new devices with multiple shapes and sizes is needed to improve the results of this intervention. 4,5 In patients with mitral valve prosthesis who develop PVL and are at high surgical risk, a transapical transcatheter correction is an alternative therapy that can be successfully performed, with significant clinical improvement for the patient.…”

“…1 In severe cases, the condition leads to intense blood regurgitation, heart failure and hemolysis, and a new surgical intervention may be indicated. 2 Although re-operation has been established as the gold standard for PVL correction, transcatheter closure has emerged as an alternative treatment for patients at high surgical risk, considering the poor prognosis resulting from re-operation in these patients, in whom an increase in the number of re-interventions leads to a progressive increase in mortality rates. 3 We describe a case of mitral PVL in a patient at high surgical risk, who underwent a transapical transcatheter correction with the implantation of three Amplatzer TM Vascular Plug II devices.…”