Transcatheter mitral paravalvular leak closure with the KONAR occluder device

A 70-year-old man underwent mitral and aortic valve replacement (Björk-Shiley, Pfizer, United States) in 1976, requiring a second aortic valve replacement (On-X, On-X Life Technologies, United States) with tricuspid annuloplasty in 2009. Subsequently, a symptomatic aortic paravalvular leak (PVL) was successfully treated with a 14/5-mm Amplatzer Vascular Plug III (Abbott, United States). The patient was later admitted for hemolytic anemia, when a new 11 × 3 mm mitral PVL was discovered. A percutaneous strategy was decided upon. Under 3-dimensional transesophageal echocardiographic guidance and through a transseptal approach, the defect was crossed with a hydrophilic wire over a multipurpose catheter, requiring the use of a steerable introducer Agilis (Abbott, United States). An arteriovenous loop was created, and a 14-mm KONAR-MF VSD Occluder (LifeTech Scientific, China) (figure 1) was successfully deployed using a 6-Fr delivery sheath (figure 2 and figure 3; yellow arrow. Videos 1 and 2 of the supplementary data), without significant residual leak or prosthesis interference. Figure 1. Figure 2. Figure 3. Transcatheter PVL closures have been increasingly performed in recent years. The presence of a monodisc prosthesis (Björk-Shiley) with an extremely serpiginous PVL can be particularly challenging. At this point, we consider the Konar-MF could potentially perform better...