Percutaneous closure of paravalvular leak after transcatheter valve implantation in mitral annular calcification

Figure 1. Multimodality imaging of the paravalvular leak and the procedure. A) Transoesophageal echo (TOE) image showing the initial severe paravalvular leak (Moving image 1). B) CT image demonstrating an important anterolateral arch-shaped gap between the annular calcification and the bioprosthesis (indicated by the asterisk). C) The simultaneous positioning of two AMPLATZER Vascular Plug III occluders (5×14 mm) allows an obstruction of the defect between the mitral prosthesis and the calcified mitral annulus (D, occluders are indicated by arrows) along with an important reduction of the regurgitation (E and Moving image 2).

A single-stage transapical aortic then mitral valve implantation ...