Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches

Figure 4

Angiogram taken during the transcatheter closure of the mitral PVL closure via an anterograde transseptal approach and arteriovenous wire loop approach. (a) The femoral venous access was followed by a transseptal puncture. (b) The introducer sheath was advanced into the left ventricle from the femoral vein. (c) The occluder was delivered into the left ventricle. (d) The occluder was deployed. (e) The transseptal puncture was followed by snaring the wire for setting up the arteriovenous loop. (f) The introducer sheath was advanced into the left ventricle via the arteriovenous loop. (g) The occluder was partially placed at the position of the paravalvular leak. (h) The occluder was deployed. The black arrow shows the paravalvular leak. The white arrow shows the occluder.

(a)

(b)

(c)

(d)

(e)

(f)

(g)

(h)