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Paravalvular leak transcutaneous closure, diagnosis, and procedure essential steps.

Mghaieth Zghal Fathia, Farhati Abdeljelil, Boudiche Slim, Manel Ben Hlima, Rekik Bassem Ouali Sana, Mourali Mohamed Sami

Paravalvular Leaks (PVLs) are a complication of a surgical or percutaneous valve replacement. They are persistent defects between the native annulus and the sewing ring, which result in a regurgitant prosthesis. They are detected in 2%-18% of patients after a surgical valve replacement. Clinical manifestations of PVLs are seen in 1% to 5% of defects and have a severe prognosis. Surgery redux was the only available treatment to improve these patients? outcomes. But it is usually a high-risk surgery in frail patients with a long history of valve disease. Percutaneous PVL closure emerged as a safer and vital therapeutic option with promising results. Nevertheless, this technique needs a careful pre-procedural assessment and demands high technical expertise. It still has several limitations. This article focuses on PVLs after a surgical valve replacement and essential steps toward assessment, indication, and achievement of a transcatheter PVL closure (TPVL).