Original Research Articles
Journal of Structural Heart Disease, May 2015, Volume 1, Issue 1:9-19
Real-Time 3D Transesophageal Echocardiographic Guidance of Prosthetic Valve Paravalvular Leak
University of Chicago Medical Center, Section of Cardiology, Chicago, Illinois, USA
The first two authors contributed equally to the manuscript.
Paravalvular leak (PVL), defined as retrograde blood flow adjacent to an annuloplasty ring or prosthetic valve, is a rare but serious complication of heart valve surgery. Though most PVLs are asymptomatic, 1–5% of patients develop serious clinical consequences such as heart failure, endocarditis, or hemolysis. Surgical repair may be necessary in severe cases, however for those who are at high surgical risk, a percutaneous approach can be performed to occlude these defects. Real-time three-dimensional transesophogeal echocardiography (3DTEE) during percutaneous closure procedures is invaluable for intra-procedural guidance. In this article, we will review the literature and outline two cases where real-time 3DTEE guidance was critical for successful closure of symptomatic PVL.
Video 1Video 1: Annuloplasty ring dehiscence.
Video 2Video 2: Mechanical mitral prosthetic dehiscence.
Video 3Video 3: Case 1: Mechanical mitral prosthesis with paravalvular leak in the 4 o’clock position.
Video 4Video 4: Case 1: 3D acquisition of 6 mm occluder device expansion.
Video 5Video 5: Case 2: Fluoroscopy showing evidence of entrapment of the posterior mechanical mitral valve leaflet.
Video 6Video 6: Case 2: 2D TEE showing evidence of entrapment of the posterior mechanical mitral valve leaflet.
Video 7Video 7: Case 2: 2D color Doppler TEE showing evidence of entrapment of the posterior mechanical mitral valve leaflet.
Cite this article as: Venturini JM, Mediratta A, Addetia K, Nathan S, Shah AP, Lang RM. Real-Time 3D Transesophageal Echocardiographic Guidance of Prosthetic Valve Paravalvular Leak. Structural Heart Disease 2015;1(1):9-19. DOI: 10.12945/j.jshd.2015.00011-14
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