Paravalvular leak (PVL) post-transcatheter aortic valve replacement (TAVR) is challenging to close due to presence of transcatheter valve frame and calcium along the leak. We adopted the “retro-antegrade” approach to facilitate catheter and device delivery in closing 3 SAPIEN-3 (Edwards Lifesciences) PVL 3, 5 and 1-month post-TAVR respectively due to bulky left ventricular outflow tract (LVOT) calcium. Single arterial access for a 14Fr DrySeal sheath (Gore) were used in all patients.
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