June 12, 2026Catheterization and Cardiovascular Interventions
Prison Break: Extraction of a Plug Jailed Between Two Mechanical Valves
Key result
Percutaneous retrieval of an embolized vascular plug and immediate PVL re-closure successfully restores mechanical valve function.
- n=1
Why the study?
Device migration after transcatheter paravalvular leak closure is uncommon but can be catastrophic when impinging on mechanical valve performance, and management in patients at prohibitive surgical risk is challenging.
Population
A 37-year-old woman with prior mechanical mitral and aortic valve replacements and mitral PVL
Comparison
Percutaneous retrieval of an embolized device followed by immediate re-closure of the PVL
Design
Case report
Authors
Discussion
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Implication
Supports feasibility of bailout transcatheter PVL closure in prohibitive-risk cases; leaves open randomized confirmation versus surgery.
Key Points
- This case aims to address the management of paravalvular leak and the implications of device migration in patients at high surgical risk.
- Reported case of a 37-year-old woman with recurrent heart failure due to mitral paravalvular leak.
- Performed transcatheter closure with Amplatzer Vascular Plug III devices; followed by retrieval of an embolized device through the aortic valve and immediate re-closure of the leak.
- Evaluated hemodynamic stability post-intervention.
- Achieved substantial reduction of regurgitation after initial transcatheter closure.
- Addressed acute pulmonary edema by retrieving the migrated device while restoring valve function immediately thereafter.
- Successfully demonstrated the feasibility of advanced bailout strategies in patients with prohibitive surgical risks.
Study Design
Type
Case Report (n=1)
Structured PICO
P
Population
1 37-year-old woman with prior mechanical mitral and aortic valve replacements, complicated by recurrent heart failure due to a mitral paravalvular leak (PVL) resulting from suture dehiscence.
I
Intervention
Percutaneous retrieval of an embolized Amplatzer Vascular Plug III device from the left ventricular outflow tract, followed by immediate re-closure of the PVL.
O
Outcome
Restoration of valve function and hemodynamic stability
This case demonstrates the feasibility of percutaneous retrieval of an embolized paravalvular leak closure device through a mechanical prosthesis and immediate re-closure in a patient at prohibitive surgical risk.
Cite This Study
Chaddad et al. (2026) conducted a case report in Mitral paravalvular leak with device migration (n=1). Percutaneous retrieval of embolized device and re-closure of PVL was evaluated on Restoration of valve function and hemodynamic stability. Percutaneous retrieval of an embolized Amplatzer Vascular Plug III through a mechanical prosthesis, followed by immediate re-closure of the paravalvular leak, successfully restored valve function.