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Review
. 2024 May;47(5):e24272.
doi: 10.1002/clc.24272.

Complications of transcatheter paravalvular leak device closure of mitral valve: An updated review of the literature and a rare case presentation

Yaser Jenab  1 , Saeed Nourian  2 , Negin Sadat Hosseini Mohammadi  1   3 , Reza Mohseni-Badalabadi  1 , Kaveh Hosseini  1   3 , Sarina Zakavi  1   4 , Ismail Ates  5
Affiliations
Review

Complications of transcatheter paravalvular leak device closure of mitral valve: An updated review of the literature and a rare case presentation

Yaser Jenab et al. Clin Cardiol. 2024 May.

Abstract

Paravalvular leak (PVL) is an uncommon complication of prosthetic valve implantation, which can lead to infective endocarditis, heart failure, and hemolytic anemia. Surgical reintervention of PVLs is associated with high mortality rates. Transcatheter PVL closure (TPVLc) has emerged as an alternative to surgical reoperation. This method provides a high success rate with a low rate of complications. This article reviews the pathogenesis, clinical manifestation, diagnosis, and management of PVL and complications following TPVLc. Besides, we presented a case of a patient with severe PVL following mitral valve replacement, who experienced complete heart block (CHB) during TPVLc. The first TPVLc procedure failed in our patient due to possible AV-node insult during catheterization. After 1 week of persistent CHB, a permanent pacemaker was implanted. The defect was successfully passed using the previous attempt. Considering the advantages of TPVLc, procedure failure should be regarded as a concern. TPVLc should be performed by experienced medical teams in carefully selected patients.

Keywords: heart failure; hemolytic anemia; paravalvular leak; percutaneous closure; valvular prosthesis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) TEE 4 chamber view. Dehiscence of the medial side of MV sewing ring. Severe paravalvular leakage (yellow arrow). (B) TEE parasternal view. Dehiscence of the anterior side of MV sewing ring. Severe paravalvular leakage. (C) 3D TEE color. Surgical view of prosthetic MV (black arrow) with paravalvular leakage (yellow arrow). (D) Surgical view of prosthetic MV (black arrow) with a paravalvular defect in the anteromedial side of MV sewing ring (yellow arrow). TEE, transesophageal echocardiography.
Figure 2
Figure 2
Finally PDA occluder size 15 was implanted with no complication. PDA, patent ductus arteriosus.
Figure 3
Figure 3
TEE showed mild residual paravalvular leakage. TEE, transesophageal echocardiography.
See this image and copyright information in PMC

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