The heart in our hands: pathway to a three-dimensional problem solution

Abstract

Percutaneous closure of paravalvular leaks (PVLs) after aortic valve replacement has emerged as an effective - and often first-line - choice for patients with significant paravalvular regurgitation requiring intervention. The defect can be approached via different routes (antegrade transseptal, retrograde transaortic, or transapical) based on the position of the valve, location of the defect and operator expertise. Several imaging modalities have been used, but predicting the number and size of devices to be implanted remains challenging.