Percutaneous closure of a large aortic paravalvular leak using two duct occluder devices

A 21-year-old male presented with severe aortic paravalvular leak. He had undergone three cardiac surgeries and also had chronic kidney disease. It was decided for a trans-catheter closure owing to the risks of a fourth surgery and co-morbidity. The device was sized based on angiogram, balloon sizin...

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Bibliographic Details
Published inIndian heart journal Vol. 65; no. 3; pp. 283 - 285
Main Authors Sasikumar, Navaneetha, Rajasekar, Premsekar, Suramanyan, Raghavan
Format Journal Article
LanguageEnglish
Published India Elsevier, a division of RELX India, Pvt. Ltd 01.05.2013
Elsevier
Subjects
Aortic Valve Insufficiency - surgery
Cardiac surgical procedures
Cardiovascular
Complications
Coronary Angiography
Echocardiography, Transesophageal
Heart Septal Defects, Ventricular - surgery
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects
Humans
Male
Mitral Valve Insufficiency - epidemiology
Original
Paravalvular leak
Percutaneous closure
Postoperative Hemorrhage - etiology
Postoperative Hemorrhage - therapy
Prosthesis Implantation - instrumentation
Prosthesis Implantation - methods
Septal Occluder Device
Valvular heart disease
Young Adult
Valvular heart disease
Cardiac surgical procedures
Complications
Paravalvular leak
Percutaneous closure
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Summary:A 21-year-old male presented with severe aortic paravalvular leak. He had undergone three cardiac surgeries and also had chronic kidney disease. It was decided for a trans-catheter closure owing to the risks of a fourth surgery and co-morbidity. The device was sized based on angiogram, balloon sizing and two dimensional transesophageal echo. There was significant residual leak after deployment of first device. Hence the defect was re-crossed and two duct occluder devices were positioned across the leak from two arterial access. After confirming position and satisfactory reduction in paravalvular leak, the devices were released in tandem. There was near abolition of leak. The patient is asymptomatic at three months follow up. Larger paravalvular leaks are better addressed with two devices of smaller size rather than a single large device. Technical considerations while deploying multiple devices are discussed.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:0019-4832
DOI:10.1016/j.ihj.2013.04.020