The synergistic integration of real-time 3D transesophageal echocardiography and 3D printing successfully guided the transcatheter closure of multiple mitral perivalvular leaks via a left ventricular apical approach.
Case Report (n=1)
No
The integration of real-time 3D TEE and 3D printing provides complementary anatomical detail that can successfully guide transcatheter closure of complex, multiple perivalvular leaks.
Accurate assessment of perivalvular leak (PVL) morphology following valve replacement remains a significant clinical challenge. Precise characterization of PVL anatomy is essential, as different leak patterns require distinct management strategies. We report a case in which two complementary imaging modalities—real-time three-dimensional (RT-3D) transesophageal echocardiography (TEE) and three-dimensional (3D) printing technology—were successfully utilized to evaluate PVL morphology and guide the subsequent surgical approach. A 63-year-old woman with a history of mechanical mitral valve replacement was found to have a PVL on follow-up transthoracic echocardiography (TTE), but the number and morphology could not be fully determined. Initial 3D printing based on cardiac computed tomography angiography (CTA) depicted only one defect; however, subsequent RT-3D TEE revealed two adjacent leaks. Based on TEE findings, the 3D printing parameters were adjusted, allowing visualization of both leaks. These imaging results informed a tailored interventional strategy, and transcatheter closure of the mitral PVLs was successfully performed via left ventricular apical access under real-time TEE guidance. The synergistic integration of RT-3D TEE with color Doppler and 3D printing technology offers complementary strengths in the morphological assessment of complex or multiple PVLs, highlighting its potential clinical value in selected challenging cases.
Wang et al. (2026) conducted a case report in Multiple perivalvular leaks after mitral valve replacement (n=1). Real-time 3D transesophageal echocardiography and 3D printing guided transcatheter closure was evaluated on Procedural success and symptom resolution. The synergistic integration of real-time 3D transesophageal echocardiography and 3D printing successfully guided the transcatheter closure of multiple mitral perivalvular leaks via a left ventricular apical approach.