Paravalvular leaks and VSD percutaneous closure - Recorded cases

Recorded case 1: A 56-year-old female with a prior mechanical mitral valve replacement (Star GK, 2018), permanent AF, and normal LV function presented with recurrent HF admissions due to paravalvular leaks. She was treated with implantation of multiple plugs via a transseptal approach using a Destination guiding catheter, under general anesthesia and TEE guidance.

Recorded case 2: A 63-year-old male presented with an inferior STEMI treated by primary PCI of the RCA and circumflex artery. Two weeks later, he was hospitalized for heart failure due to a large inferior VSD. A 14 mm occluder device was implanted via jugular venous access under general anesthesia and TEE guidance. Device sizing was determined using balloon measurement.

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Key moments

• 12:46–13:08 – Placement of the destination guiding
• 13:22–21:03 – Plugs release
• 26:10–31:24 – Procedural analysis
• 39:54–40:20 – Venous jugular punction under echo
• 40:40–49:22 – VSD balloon sizing and plug placement

Keywords: Paravalvular leak, VSD-venous jugular access, Paravalvular plug, VSD plug