Percutaneous treatment of mitral valve periprosthetic leakage. An alternative to high-risk surgery?

Periprosthetic mitral valve regurgitation due to paravalvular leakage is one of the complications of valve replacement surgery. We report a series of eight patients with severe symptomatic periprosthetic mitral regurgitation in whom surgery could not be performed because of the high risk. All patients were assigned to percutaneous closure of periprosthetic mitral valve leaks using an Amplatzer duct occluder. The procedure was successful in five patients. A significant reduction in periprosthetic regurgitation and a clinical improvement were observed in four of the patients. The procedure was unsuccessful in three patients: in two due to interference with the prosthesis discs; in the other, because it was not possible to pass through the leak. One of these three patients died a few hours after the procedure due to severe stroke. Percutaneous closure of paravalvular leakage in patients at a high surgical risk is technically feasible and has an acceptable clinical success rate.