IVUS guidance in percutaneous closure of aortic paraprosthetic leak

Severe aortic regurgitation due to paraprosthetic leak appears in 1-5% of patients with previous aortic valve replacement. Surgical management is the treatment of choice but has high morbidity and mortality and leak recurrence is not uncommon. Different approaches to percutaneous closure have been tried. Transesophageal echocardiography (TEE) is a key factor to measure and localize leakages. Performing TEE during the procedure implies general anesthesia and prolongs procedure and fluoroscopy times. We report the case of an aortic paraprosthetic leak percutaneous closure using intravascular ultrasound to guide the procedure.