Percutaneous closure of multiple mitral paravalvular leaks

Sixty-six-year-old male patient with a past medical history of mitral and aortic valve replacement in 1983. Back in 2005 he underwent a new aortic valve replacement due to prosthetic valve dysfunction. In 2018, also due to prosthetic valve dysfunction, a new mitral valve replacement was performed with a size 27 Bicarbon Fitline heart valve (Sorin Group, Italy). Three months later the patient was hospitalized with functional class III-IV heart failure according to the New York Heart Association (NYHA) and hemolytic anemia with multiple mitral paravalvular leaks quantified as severe regurgitation. In a single medical-surgical session it was decided to perform percutaneous treatment due to the patient’s high surgical risk. The percutaneous closure of the leaks was performed using 7 Amplatzer Vascular Plug III devices (figure 1E) that resulted in minimal residual leaks