The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Paravalvular leak after transcatheter valve implantation in mitral annular calcification: First report of a percutaneous closure with Amplatz Vascular Plugs-III occluders.

DOI: 10.4244/EIJ-D-19-00744

1. Univ Rennes1, Department of Cardiology, CHU Rennes, Inserm, LTSI-UMR 1009, F-35000 Rennes, France, France
2. Univ Rennes 1, Department of Cardiology, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000 Rennes, France

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A single-stage transapical aortic then mitral valves implantation was performed  in a 68 years-old man. Regarding the mitral valve, an Edwards Sapien3 29 mm bioprosthesis (Edwards Lifesciences, Irvince, CA) was implanted in severe mitral annular calcifications (MAC). Despite an initial success, the patient suffered a pulmonary edema 1 month after the initial procedure. Echographic and computed tomography analyses revealed a well-functioning aortic prosthesis and a delayed migration of the mitral prosthesis towards the left atrium, resulting in a severe paravalvular leak (PVL) (figures 1 A and 1B, motion 1). This PVL was located in the antero-lateral part of the mitral valve, with an arch-shaped aspect, measured at 8x16 mm.

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