Key result
Coronary stenting successfully manages vascular plug-induced left main obstruction complicating paravalvular leak closure.
Why the study?
Transcatheter closure of paravalvular leak can cause rare complications such as coronary obstruction from vascular plug devices.
Case Report (n=1)
No
Coronary obstruction is a rare but serious complication of transcatheter paravalvular leak closure that can be effectively managed with coronary stenting.
Device-related left main obstruction after paravalvular leak closure may be amenable to stenting; single case leaves open need for systematic evaluation.
BACKGROUND: Paravalvular leak (PVL) is a relatively rare complication associated with prosthetic valve replacement, which in some cases can lead to congestive heart failure or complications of hemolysis. CASE SUMMARY: A 65-year-old man with prior surgical aortic valve replacement presented with symptoms of dyspnea, reduced left ventricular ejection fraction, and interval development of severe PVL. DISCUSSION: PVL can be managed either surgically or percutaneously. Although transcatheter closure is less invasive, it can cause rare complications such as coronary obstruction from vascular plug devices. Through this case, we show how to effectively manage such complications with coronary stenting in a patient with a large aortic PVL and low left coronary ostia. TAKE-HOME MESSAGES: Coronary obstruction is a rare but serious complication of PVL closure device. It may be caused by device position or thrombus. Assessment requires multimodality imaging. Coronary stenting can effectively manage and prevent adverse events.
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Lateef et al. (2025) conducted a case report in Paravalvular leak after surgical aortic valve replacement (n=1). Percutaneous paravalvular leak closure with Amplatzer vascular plug 2 and left main coronary stenting was evaluated on Resolution of paravalvular leak and coronary obstruction. In a patient with severe paravalvular leak, left main coronary obstruction caused by a vascular plug closure device was successfully managed with coronary stenting.
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