Percutaneous closure of an aortic paravalvularleak with the SearCare PDA occluder

• S.A. Abugov
• V.V. Raskin
• M.V. Puretsky
• Frolova Yu.V.
• Mardanyan G.V.
• T.A. Buravikhina
• Dombrovskaya A.V.
• Sergey L. Dzemeshkevich

Abstract

Paravalvular leak (PVL) following to aortic valve replace- ment increases mortality and can result to heart failure, that requires treatment. Re-operation is still the treat- ment of choice, but it is associated with a high risk of complication. Recently, endovascular (percutaneous) closure of paravalvular leaks with occluders (or coils) have become an alternative to surgery. We describe the percutaneous closure of an aortic paravalvular leak in a 72-year-old woman, who had undergone aortic valve replacements with biological prosthesis. The patient, who was at high surgical risk due to comorbidities, underwent the endovascular implantation of SearCare PDA occluder 8x10mm device accompanied by radiography and transesophageal echocardiography. The early and mid term outcomes of the procedure were favorable, the degree of aortic regurgitation decreased from AR 3–4 to AR 1. Percutaneous closure of PVL using the occluder devices is feasible, but technically demanding procedure. We think that cardiothoracic surgeons and intervention- al cardiologists should collaborate in the evaluation the risk and benefit of reoperation or percutaneous closure of paravalvular leaks.

Keywords:aortic valve replacement, paravalvular leak, endovascular occluder

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