Key result
Novel transcatheter covered stent-nitinol occluder successfully repairs complex mitral PVL and LV pseudoaneurysm.
Why the study?
Re-operation for paravalvular leak and left ventricular pseudoaneurysm carries high risk, while transcatheter management remains difficult due to potential device instability and mechanical leaflet interference.
Case Report (n=1)
A novel transcatheter approach using a covered stent-nitinol occluder combination can successfully manage complex mitral paravalvular leaks with adjacent pseudoaneurysms when standard devices are unsuitable.
Answers are grounded in this paper and cite their sources.
Transcatheter closure may be viable for select early postoperative mitral PVL with pseudoaneurysm; leaves open safety and efficacy in larger series.
Paravalvular leak (PVL) and left ventricular pseudoaneurysm can develop after surgical valve replacement, often as a result of suture dehiscence and annular disruption, potentially causing refractory heart failure. While re‐operation poses a high risk, transcatheter PVL management remains equally difficult due to the possibilities of device instability and interference with mechanical prosthesis leaflets. We present an early postoperative mitral PVL that was connected to a large left ventricular pseudoaneurysm, in which standard PVL closure devices would have restricted leaflet movement. A novel transcatheter approach was developed with virtual reality simulation, and implemented through a combined transseptal and percutaneous transapical access to deploy a covered stent across the PVL for exclusion of the pseudoaneurysm, followed by device closure of the stent lumen.
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Sagar et al. (2026) conducted a case report in Mitral paravalvular leak and left ventricular pseudoaneurysm (n=1). Transcatheter management using a covered stent-nitinol occluder combination was evaluated. A novel transcatheter approach using a covered stent-nitinol occluder combination was successfully implemented to manage a complex mitral paravalvular leak and left ventricular pseudoaneurysm.
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