Key result
Percutaneous closure with dedicated devices successfully resolves moderate-to-severe PVL after third-generation TAVR in high-risk cases.
Why the study?
Significant paravalvular leak regurgitation after TAVR has poor prognostic implications, and percutaneous closure is an effective but technically challenging treatment option for high-risk patients.
Case Report (n=2)
This case series demonstrates strategies for successful percutaneous closure of paravalvular leak regurgitation following third-generation TAVR.
Supports feasibility in select high-risk patients; leaves open need for prospective data on durability and outcomes.
Significant paravalvular leak regurgitation (PVLR) after transcatheter aortic valve replacement (TAVR) is a well-known complication associated with disabling symptoms related to heart failure and hemolysis or both, with poor prognostic implications. Although challenging and technically demanding, percutaneous closure is an effective treatment option for high-risk patients with symptomatic PVLR. Here, we present two cases of transcatheter PVLR closure after replacement of third-generation (one self-expandable and one balloon-expandable) transcatheter aortic valves, each with peculiar challenges, and the strategies adopted to increase the success rate of percutaneous closure.
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Onorato et al. (2021) conducted a case report in Paravalvular leak regurgitation after transcatheter aortic valve replacement (n=2). Percutaneous paravalvular leak closure (Occlutech PLD) was evaluated on Procedural success and reduction of regurgitant jet. Percutaneous closure of moderate-to-severe paravalvular leak regurgitation using dedicated devices after third-generation transcatheter aortic valve replacement was successful in two high-risk patients.
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