Percutaneous closure of mitral paravalvular leak via retrograde approach: with use of the Amplatzer duct occluder II and without a wire loop.

The gold-standard treatment for prosthetic-valve paravalvular leakage is surgery to repair or replace the valve; however, the morbidity and mortality rates cannot be ignored, and some patients are poor surgical candidates. The percutaneous closure of such defects is possible, and different devices are being used for this purpose. In almost all instances, a femorofemoral or femorojugular wire loop is constructed to deliver the closure device. Herein, we present the case of a 61-year-old man in whom a mitral paravalvular leak was successfully closed with use of the Amplatzer Duct Occluder II, via retrograde approach under 3-dimensional transesophageal echocardiographic guidance, without the use of a wire loop. To the best of our knowledge, this is the 1st report of retrograde device deployment without the construction of an arteriovenous wire loop, and the 1st case in which the Amplatzer Duct Occluder II was used for the percutaneous closure of a mitral paravalvular leak.