Key result
Percutaneous nonfluoroscopic mitral PVL closure proves feasible and safely eliminates ionizing radiation in selected patients.
Why the study?
Mitral paravalvular leak is a serious complication after mechanical mitral valve replacement, prompting the description of a percutaneous and nonfluoroscopic technique guided exclusively by TEE to eliminate radiation exposure.
Is a percutaneous and nonfluoroscopic approach guided exclusively by TEE feasible and safe for mitral paravalvular leak closure?
Is a percutaneous and nonfluoroscopic approach guided exclusively by TEE feasible and safe for mitral paravalvular leak closure?
A percutaneous, nonfluoroscopic approach guided exclusively by TEE is a feasible and safe technique for closing mitral paravalvular leaks while eliminating radiation exposure.
Answers are grounded in this paper and cite their sources.
May enable radiation-free mitral PVL closure in selected patients; leaves open need for prospective validation before wider adoption.
OBJECTIVE: Mitral paravalvular leak (PVL) is a serious complication after mechanical mitral valve replacement. We describe a step-by-step percutaneous and nonfluoroscopic (PAN) technique for mitral PVL closure guided exclusively by transesophageal echocardiography (TEE) to eliminate radiation exposure. KEY STEPS: First, preprocedural anatomical assessment and device sizing use cardiac computed tomography and TEE. Next, under TEE guidance, transseptal puncture is performed, followed by steerable sheath positioning in the left atrium. Then, a guidewire is advanced across the defect, and a delivery sheath is positioned. Finally, an adequate working distance is established to ensure that the Amplatzer vascular plug is precisely deployed without interfering with the mechanical valve discs. POTENTIAL PITFALLS: The PAN approach relies on high-quality TEE windows; suboptimal imaging or complex, calcified leaks may require fluoroscopic assistance. TAKE-HOME MESSAGE: The PAN approach for mitral PVL closure is a feasible and precise strategy that eliminates ionizing radiation while maintaining procedural safety in selected patients.
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Luo et al. (2026) studied Mitral paravalvular leak (PVL). Percutaneous and nonfluoroscopic (PAN) technique for mitral PVL closure was evaluated. The percutaneous and nonfluoroscopic approach for mitral paravalvular leak closure is a feasible strategy that eliminates ionizing radiation while maintaining procedural safety in selected patients.
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