Department of Cardiac Surgery, 378967Hôpitaux Universitaires Henri Mondor, Créteil, France.
Advanced Surgical Technologies, Sapienza University of Rome, Rome, Italy.
Perfusion. 2023 Mar;38(2):432-435. doi: 10.1177/02676591211057505. Epub 2022 Mar 15.
Paravalvular leak (PVL) is a recognized and challenging complication after surgical or transcatheter valve replacement. The transcatheter closure of PVL has become the first-line treatment in clinical practice when the procedure is not contraindicated. Transcatheter PVL closure rests on a complex procedure and complications still occur in approximately 9% of patients. We describe the case of a delayed mechanical prosthetic leaflet impingement after transcatheter closure of a paravalvular leak associated with a Valsalva pseudoaneurysm that required an urgent surgery. Aorta-left ventricle communication could be a relative contraindication to be assessed on a case-by-case basis, but transcatheter closure does not preclude subsequent attempt for surgical repair and outcome.
瓣周漏（PVL）是心脏瓣膜置换术后一种公认且具有挑战性的并发症。在无手术禁忌证的情况下，经导管 PVL 封堵术已成为临床实践中的首选治疗方法。经导管 PVL 封堵术是一个复杂的过程，大约仍有 9%的患者会发生并发症。我们描述了一例经导管封堵瓣周漏后发生延迟性机械瓣叶撞击的病例，该患者还合并有瓦氏窦假性动脉瘤，需要紧急手术治疗。主动脉-左心室交通可能是相对禁忌证，需要具体情况具体分析，但经导管封堵术并不排除随后进行外科修复的可能性和良好结局。
