Transcatheter Closure of Paravalvular Leak Using a Dedicated Occluder Device: Our Initial Experience with Occlutech PLD Occluder in a Complex Redo-Aortic Patient

BACKGROUND Paravalvular leak (PVL) following surgical aortic valve replacement is associated with significant morbidity, including heart failure and transfusion-dependent haemolytic anaemia. Transcatheter device closure, in contrast to surgical treatment, is a well-recognized treatment option due to its safer complication and mortality profiles. However, regional data and local experience showed that most PVL closures were done using non-dedicated devices which are not purposefully engineered to meet its specific pathology and anatomical complexity. OBJECTIVE To evaluate the feasibility and demonstrate procedural outcome using the Occlutech PLD Occluder device, a dedicated PVL closure device. CASE SUMMARY A 52-year-old man with prior Stanford type A aortic dissection repair, and redo aortic arch replacement with bioprosthetic aortic valve replacement, presented with progressive dyspnoea and transfusion-dependent haemolytic anaemia. Echocardiography confirmed the presence of PVL which was successfully closed with transcatheter strategy, using an Occlutech PLD 61PLD8W Occluder. RESULTS The Occlutech PLD Occluder device was successfully deployed with satisfactory results leading to significant improvement in patient’s symptoms. CONCLUSION The usage of a dedicated PVL closure device yielded positive outcome in our early experience, and supports broader availability and further evaluation of dedicated PVL closure devices in this setting.