Percutaneous transcatheter closure of mitral paravalvular leak via transarterial retrograde approach

作     者：Ho-Ping Yu Chi-Hung Huang Shaw-Min Hou Ming-Chon Hsiung Shen-Kou Tsai Wei-Hsian Yin 

作者机构：Heart Center Cheng-Hsin General Hospital Taipei Taiwan China Division of Cardiology Cathay General Hospital Taipei Taiwan China Division of Cardiac Surgery Cathay General Hospital Taipei Taiwan China Department of Anesthesiology Cheng-Hsin General Hospital Taipei Taiwan China Faculty of Medicine School of Medicine National Yang Ming University Taipei Taiwan China 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2015年第12卷第6期

页      面：683-686页

核心收录：

学科分类：0710[理学-生物学] 080706[工学-化工过程机械] 07[理学] 08[工学] 0807[工学-动力工程及工程热物理] 071002[理学-动物学] 

主　　题：Antegrade approach Paravalvular leaks Prosthetic valve Retrograde approach Wire loop 

摘      要：Repeat surgery has usually been considered the first choice to solve paravalvular leaks of prosthetic valves, but it cames a high operative risk, a high mortality rate and an increased risk for re-leaks. Percutaneous closure of such defects is possible, and different approaches and devices are used for this purpose. For mitral paravalvular leaks, constructing an arterio-venous wire loop for delivering the closure device through an antegrade approach is the most commonly used technique. Transcatheter closure can also be performed through a transapical approach or retrograde transfemoral arterial approach. We present a case of 68-year-old man with a mitral paravalvular leak that was suc- cessfully closed using an Amplatzer~ Duct Occluder H, via retrograde transfemoral arterial approach under three-dimensional transesophag- eal echocardiographic guidance, without the use of a wire loop. The initial attempt to cross the paravalvular defect was unsuccessful, but the obstacle was finally overcome by introducing complex interventional techniques.