Transcatheter Mitral and Aortic Paravalvular Leak Closure: Innovations, Challenges, and Future Directions

Paravalvular leak (PVL) is a well-known complication of valve replacement, occurring in up to 10% of aortic and 17% of mitral prosthetic valves. Although many leaks are small and clinically insignificant, ≈1% to 5% of cases are associated with clinically relevant complications, such as heart failure symptoms and hemolytic anemia. Surgical reoperation is currently considered the first-line option; however, it encompasses high mortality and morbidity risks. In the past years, transcatheter PVL closure has proven to be highly effective when performed in experienced centers. Transcatheter PVL closure requires advanced imaging modalities, specialized materials, and techniques, reflecting the high complexity of the procedure. We review the complex nature of PVL, including its diagnostic workup and the available transcatheter treatment strategies, with a special focus on the treatment of mitral and aortic PVL using plugging devices.

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Publication Details

Journal
Circulation Cardiovascular Interventions
Published
2026-02-19
DOI
https://doi.org/10.1161/circinterventions.125.015984
Primary Topic
Cardiac Valve Diseases and Treatments
Type
article
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article

Transcatheter Mitral and Aortic Paravalvular Leak Closure: Innovations, Challenges, and Future Directions

Eric Horlick, Eduardo Flores‐Umanzor, Grzegorz Smołka, Laura Sanchís et al.
Circulation Cardiovascular Interventions
Cardiac Valve Diseases and Treatments
article

Transcatheter Mitral and Aortic Paravalvular Leak Closure: Innovations, Challenges, and Future Directions

Eric Horlick, Eduardo Flores‐Umanzor, Grzegorz Smołka, Laura Sanchís, B. Vidal, M. Sitges, XR Freixa, I Cruz-Gonzalez, Andrea Ruberti, Guillermo Velázquez, Ander Regueiro, Mark Osten, Pedro Cepas-Guillén, Thomas Pilgrim, Gabor G. Toth, Josep Rodes-Cabau, Nicolas Dumonteil, Gerard Martí-Aguasca, Reda Ibrahim, Patrick A. Calvert, Giovanni Occhipinti, Philippe Garot, Sebastien Hascoët, Omar Abdul-Jawad Altisent, Eustaquio Maria Onorato
article en

Abstract

Paravalvular leak (PVL) is a well-known complication of valve replacement, occurring in up to 10% of aortic and 17% of mitral prosthetic valves. Although many leaks are small and clinically insignificant, ≈1% to 5% of cases are associated with clinically relevant complications, such as heart failure symptoms and hemolytic anemia. Surgical reoperation is currently considered the first-line option; however, it encompasses high mortality and morbidity risks. In the past years, transcatheter PVL closure has proven to be highly effective when performed in experienced centers. Transcatheter PVL closure requires advanced imaging modalities, specialized materials, and techniques, reflecting the high complexity of the procedure. We review the complex nature of PVL, including its diagnostic workup and the available transcatheter treatment strategies, with a special focus on the treatment of mitral and aortic PVL using plugging devices.

Circulation Cardiovascular InterventionsVol. 19(3)
Hebron University (PS), University Health Network (CA), Inserm (FR), Medical University of Silesia (PL), Medical University of Graz (AT), Université Paris-Saclay (FR), Royal Papworth Hospital (GB), Montreal Heart Institute (CA), University Hospital of Bern (CH), Research Institute Hospital 12 de Octubre (ES), Departament de Salut (ES), Lung Institute (US), Istituto Clinico Sant'Ambrogio (IT), Vall d'Hebron Institut de Recerca (ES), Hôpital Marie Lannelongue (FR), Instituto de Investigación Biomédica de Salamanca (ES), Clinique Pasteur (FR), Institut Cardiovasculaire Paris Sud (FR), Hôpital Privé Jacques Cartier (FR), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), Bicêtre Hospital (FR)
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Openalex Percentile: Top 54%
Cardiac Valve Diseases and Treatments
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