Transapical closure of mitral prosthetic paravalvular leak.

Clinically significant mitral prosthetic paravalvular leaks may occur in up to 5% of patients following surgical mitral valve replacement. Successful closure may offer relief from symptoms of heart failure and hemolysis, but surgical closure is associated with increased morbidity and mortality. Alternative transcatheter closure techniques are being developed. We present a patient who was successfully treated via a transapical approach with deployment of an amplatzer duct occluder type I closure device under real-time two-dimensional transesophageal echocardiography.