Transcatheter Simultaneous Double-Transapical Access for Paravalvular Mitral Leak Closure Using the Occlutech PLD

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 regurgit...

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Bibliographic Details
Published in:	The Journal of invasive cardiology Vol. 28; no. 7; p. E66
Main Authors:	Pestrichella, Vincenzo, Pignatelli, Antonio, Alemanni, Rossella, Montesanti, Rosamaria, Braccio, Maurizio, Greco, Francesco, D'Ambruoso, Pierpaolo, Memmola, Cataldo Davide, Cassese, Mauro, Contegiacomo, Gaetano, Bagur, Rodrigo
Format:	Journal Article
Language:	English
Published:	United States 01-07-2016
Subjects:	Aged Cardiac Catheterization - methods Echocardiography, Doppler - methods Female Heart Failure - diagnosis Heart Failure - etiology Heart Failure - physiopathology Heart Valve Prosthesis - adverse effects Heart Valve Prosthesis Implantation - adverse effects Heart Valve Prosthesis Implantation - methods Humans Hypertension, Pulmonary - diagnosis Hypertension, Pulmonary - etiology Mitral Valve - diagnostic imaging Mitral Valve - surgery Mitral Valve Insufficiency - diagnosis Mitral Valve Insufficiency - physiopathology Mitral Valve Insufficiency - surgery Prosthesis Failure Reoperation - instrumentation Reoperation - methods Rheumatic Heart Disease - complications Septal Occluder Device Treatment Outcome
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Summary:	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.
ISSN:	1557-2501