Symptomatic paravalvular leak (PVL) complicates up to 12 % of surgical valve replacements. When patients present with congestive heart failure and/or haemolysis, reoperation for repeat valve replacement may be undertaken, but presents greater risk and lower likelihood of success than the initial operation. Therefore, percutaneous approaches to PVL closure have been developed by specialists in structural cardiac intervention. Large series demonstrate high levels of procedural success and promising clinical outcomes for this complex intervention. A thorough understanding of multimodality imaging is necessary for the diagnosis of PVL and the safe and successful performance of these closure procedures.
Amar Krishnaswamy - Associate Program Director, Interventional Cardiology Fellowship, Cleveland Clinic, Ohio, US
E Murat Tuzcu - Vice Chairman, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Ohio, US
Samir R Kapadia - Director, Sones Cardiac Catheterization Laboratories, Cleveland Clinic, Ohio, US.