Rainer Hoffmann, MD
Paravalvular leak is a frightening difficulty after surgical valve replacement. Interventional closure of paravalvular leaks has become a treatment alternative to redo surgery. However, guidance of the interventional procedure is difficult due to the complex spatial pathology to be treated. Three-dimensional transesophageal echocardiography (3D TEE) provides outstanding spatial information of complex cardiac morphologies. We report on the use of 3D TEE for guidance of interventional closure of a paravalvular leak. While our study indicates an exciting new approach for interventional guidance of paravalvular leak closure, larger studies are required.
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- Hoffmann R, Kaestner W, Altiok E. Closure of a paravalvular leak with real-time three-dimensional transesophageal echocardiography for accurate sizing and guiding. J Invasive Cardiol. 2013 Nov;25(11):E210-1.
Related articles that highlight intravascular guidance options for TAVR:
- Smolka G, Pysz P, Jasinski M, et al. Transapical closure of mitral paravalvular leaks with use of amplatzer vascular plug III. J Invasive Cardiol. 2013 Oct;25(10):497-501.
- Smolka G, Pysz P, Wojakowski W, et al. Clinical manifestations of heart failure abate with transcatheter aortic paravalvular leak closure using Amplatzer vascular plug II and III devices. J Invasive Cardiol. 2013 May;25(5):226-31.
- Sharma M, Tseng E, Schiller N, Moore P, Shunk KA. Closure of Aortic Paravalvular Leak Under Intravascular Ultrasound and Intracardiac Echocardiography Guidance. J INVASIVE CARDIOL. 2011;23:E250–E254.