New concepts in transcatheter closure of paravalvular leaks.

New catheter techniques and a large variety of endovascular devices permit transcatheter treatment - not only of common atrial or ventricular septal defects - but also of rare intracardiac malformations such as postmyocardial infarction ventricular septal defects, sinus valsalva aneurysm or paravalvular leak. Owing to the variable anatomical nature of paravalvular leaks, closure may be one of the most challenging interventional procedures in the field of structural heart disease. Current literature documents ambiguous results and endorses the limitations of this procedure. In most cases these limitations are technical. Further efforts in the development of defect-specific devices and techniques may result in an improved patient outcome and extended patient selection.