A minimal invasive transapical approach can be utilized for mitral paravalvular leak closure in patients with complex anatomy, such as those with dual mechanical prostheses, where percutaneous closure is technically difficult.
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May be feasible in select dual-prosthesis cases where percutaneous closure fails; leaves open need for comparative data before wider adoption.
Paravalvular leak is a common postoperative complication of cardiac valve replacement, leading to a significant morbidity. Leak closure surgery is usually performed in symptomatic patients. Since most patients with paravalvular leak have a high risk profile for surgical closure, percutaneous closure is the preferred treatment modality. However, complex anatomy of the defects may complicate percutaneous closure procedures, requiring substantial surgical expertise. It is unlikely to close severe mitral paravalvular leaks in patients with dual mechanical prostheses percutaneously due to technical difficulties. In this article, we report a 49-year-old male case with mitral paravalvular leak closure via transapical approach using minimal invasive surgery.
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Atila Iyısoy (2014) studied this question.
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