Intraoperative precise localization of paravalvular mitral leak by a simple surgical maneuver

Paravalvular leak after mitral valve replacement is a known surgical problem. Its management is controversial and challenging. The first and the most important step is to localize the leaking spot precisely. Echocardiogram is the standard technique that is used to localize the leak. The echocardiogram is accurate most of the time; however, in some occasions it does not easily provide the exact orientation of the leaking areas. A simple operative maneuver, which was used to allow the surgeon to localize the leak visually, and have accurate and solid repair, is described below.