Transcatheter closure of paravalvular leak after Bentall surgery in a Marfan patient: a rare case report

Paravalvular leak (PVL) following Bentall surgery in patients with Marfan syndrome is exceedingly rare. A 38-year-old Marfan patient underwent Bentall + Sun's procedure for Stanford type A aortic dissection with severe aortic regurgitation. On the third month after surgery, the patient was readmitted due to exertional dyspnea. Echocardiography revealed a paravalvular leak with significant left-to-right shunting, leading to symptoms including exertional dyspnea, hepatomegaly, and heart failure. After adequate preparation, the leak was successfully closed using a symmetric VSD occluder. Post-procedural imaging showed near-complete resolution of the leak, significant reduction in the pseudoaneurysm size, and improvement in heart failure symptoms. The patient was discharged in stable condition.