EchoNavigator® technology facilitates transapical mitral paravalvular leak closure: a case report. Issue 6 (5th June 2021)

• Record Type: Journal Article
• Authors: Buzaev, Igor Vyacheslavovich; Khalikova, Gulchachak; Plechev, Vladimir Vyacheslavovich; Onorato, Eustaquio Maria
• Editors: Nagpal, Prashant; Cosmi, Deborah; Priya, Sarv; Félix-Oliveira, Afonso; Amin, Reshma; Jakstaite, Aiste Monika
• Is Part Of: European heart journal. Volume 5:Issue 6(2021)
• Publication Date: 2021-06-05
• Subjects: Fusion imaging modalities -- Intraprocedural guidance -- Percutaneous interventions -- Paravalvular leak -- Echocardiography -- Case report; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytab190
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Catheter-based closure has emerged as a less invasive alternative to surgery in high-risk patients with paravalvular leak (PVL) and clinically significant regurgitation with feasibility and efficacy demonstrated in multiple studies. Case summary: A 72-year-old female with a past history of long-standing rheumatic heart disease underwent mechanical mitral valve replacement in 2008. Ten years later, redo surgery was performed due to a worsening mitral PVL and the leakage was closed by direct pledget-supported sutures, preserving the mechanical valve. She was recently admitted again for haemolytic anaemia and congestive heart failure (New York Heart Association Classes III–IV) due to a recurrent mitral PVL. We report our initial clinical experience using a novel software solution (EchoNavigator ® -system) for intuitive guidance during a catheter-based transapical mitral PVL closure. Discussion: Transapical mitral PVL closure with a specifically designed device demonstrated in our case to be a better option than redo surgery. Recently introduced fusion imaging modalities enhanced visualization of soft tissue anatomy and device location improving enormously the results of this challenging intervention.