Key result
Transcatheter PVL closure proves highly effective and less risky than surgery at experienced centers.
Why the study?
Surgical reoperation for clinically relevant paravalvular leak carries high mortality and morbidity risks, while transcatheter closure represents an effective but highly complex alternative requiring specialized techniques and imaging.
Transcatheter closure of paravalvular leaks is a highly effective, complex alternative to high-risk surgical reoperation when performed in experienced centers.
Answers are grounded in this paper and cite their sources.
May support transcatheter PVL closure at experienced centers; leaves open need for randomized confirmation.
Paravalvular leak (PVL) is a well-known complication of valve replacement, occurring in up to 10% of aortic and 17% of mitral prosthetic valves. Although many leaks are small and clinically insignificant, ≈1% to 5% of cases are associated with clinically relevant complications, such as heart failure symptoms and hemolytic anemia. Surgical reoperation is currently considered the first-line option; however, it encompasses high mortality and morbidity risks. In the past years, transcatheter PVL closure has proven to be highly effective when performed in experienced centers. Transcatheter PVL closure requires advanced imaging modalities, specialized materials, and techniques, reflecting the high complexity of the procedure. We review the complex nature of PVL, including its diagnostic workup and the available transcatheter treatment strategies, with a special focus on the treatment of mitral and aortic PVL using plugging devices.
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Ruberti et al. (2026) studied this question. Transcatheter closure of mitral and aortic paravalvular leaks is highly effective and less risky than surgery when performed at experienced centers.
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