What question did this study set out to answer?

The aim is to showcase an effective approach to manage a challenging paravalvular leak in a high-risk patient.

March 27, 2026Journal of the Society for Cardiovascular Angiography & InterventionsOpen Access

Secure the Plug: Ultimate Structural and Intervention Complex Paravalvular Leak Closure and Simultaneous Left Atrial Appendage Closure: Case Report

View Full Paper

Ask AI

Bookmark

Key result

Simultaneous transcatheter mitral PVL closure and LAAO is feasible and safe despite prior device interference.

Why the study?

Mitral paravalvular leak is a challenging, potentially debilitating complication of prosthetic valve implantation, particularly in the setting of prior closure attempts and complex anatomical alterations.

Population

An 83-year-old woman with recurrent severe mitral PVL and atrial fibrillation

Comparison

Transcatheter PVL closure with an Amplatzer vascular plug II and simultaneous LAAO with an Amulet device

Design

Case report

Authors

MEMohamed Elmarasi MHMohamad Bader Abo HajarBaylor Medical Center at Garland MSMohammed SalihBaylor Medical Center at Garland

Discussion

Member takes

Implication

May offer single-session solution in select high-risk cases; hypothesis-generating and requires larger studies before adoption.

Key Points

The aim is to showcase an effective approach to manage a challenging paravalvular leak in a high-risk patient.
Presented an 83-year-old female with a history of valve repair and replacement.
Utilized transcatheter techniques to close a recurrent paravalvular leak.
Performed a simultaneous left atrial appendage occlusion using a separate venous access.
Achieved successful closure of the paravalvular leak using an Amplatzer vascular plug II.
Simultaneous closure of the left atrial appendage with a 34-mm Amulet device.
Follow-up imaging confirmed complete leak closure and stable device positioning.

Structured PICO

Population

83-year-old woman with a history of robotic-assisted mitral valve repair, bioprosthetic valve replacement, complicated by a PVL previously managed with 2 Amplatzer vascular plugs, presenting with worsening heart failure symptoms, recurrent severe PVL, elevated surgical risk, and history of atrial fibrillation (n=1).

Intervention

Transcatheter closure of paravalvular leak using a third Amplatzer vascular plug II and simultaneous left atrial appendage occlusion with a 34-mm Amulet device via separate venous access.

Outcome

Procedural success and complication rate (complete PVL closure with stable device positioning).

Simultaneous transcatheter closure of a complex recurrent mitral paravalvular leak and left atrial appendage occlusion is feasible in high-risk patients with prior device interference.

Cite This Study

Elmarasi et al. (2026) studied this question. Simultaneous transcatheter closure of a complex mitral paravalvular leak and left atrial appendage occlusion is feasible and safe in high-risk patients with prior device interference.

synapsesocial.com/papers/69c6204c15a0a509bde18b8a https://doi.org/10.1016/j.jscai.2026.104274

Topics

Left atrial appendage closure Mitral valve intervention Atrial fibrillation Persistent AF management

View Full Paper

Ask AI

Bookmark

Secure the Plug: Ultimate Structural and Intervention Complex Paravalvular Leak Closure and Simultaneous Left Atrial Appendage Closure: Case Report

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Secure the Plug: Ultimate Structural and Intervention Complex Paravalvular Leak Closure and Simultaneous Left Atrial Appendage Closure: Case Report

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider