ArticleJACC. Case reports2026
Mitral Paravalvular Leak Closure Using a Percutaneous and Nonfluoroscopic Approach.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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2 authors.
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Abstract
objectiveMitral paravalvular leak (PVL) is a serious complication after mechanical mitral valve replacement. We describe a step-by-step percutaneous and nonfluoroscopic (PAN) technique for mitral PVL closure guided exclusively by transesophageal echocardiography (TEE) to eliminate radiation exposure. KEY STEPS: First, preprocedural anatomical assessment and device sizing use cardiac computed tomography and TEE. Next, under TEE guidance, transseptal puncture is performed, followed by steerable sheath positioning in the left atrium. Then, a guidewire is advanced across the defect, and a delivery sheath is positioned. Finally, an adequate working distance is established to ensure that the Amplatzer vascular plug is precisely deployed without interfering with the mechanical valve discs. POTENTIAL PITFALLS: The PAN approach relies on high-quality TEE windows; suboptimal imaging or complex, calcified leaks may require fluoroscopic assistance. TAKE-HOME MESSAGE: The PAN approach for mitral PVL closure is a feasible and precise strategy that eliminates ionizing radiation while maintaining procedural safety in selected patients.
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