Related Experiment Video
Updated: May 7, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Transapical closure of mitral paravalvular leaks with use of amplatzer vascular plug III
Grzegorz Smolka1, Piotr Pysz, Marek Jasinski
13rd Division of Cardiology, Medical University of Silesia, Ul.Ziolowa 45/47, 40-635 Katowice, Poland. grsm18@wp.pl.
Introduction:
Paravalvular leak (PVL) may complicate cardiac valve replacement surgery. Radical treatment is required if a PVL produces heart failure (HF) symptoms or severe hemolysis. Even though transcatheter PVL closure (TPVLC) has become a valid alternative to reoperation, a number of anatomical conditions may prove technically challenging for transvascular access. We intended to verify the utility of transapical access in such settings.
Methods:
We report a prospective series of 7 patients with mitral PVLs who underwent transapical TPVLC. The Heart Team made the choice of treatment and Amplatzer Vascular Plug III devices were used off-label as occluders.
Results:
Transapical TPVLC enabled excellent sealing of mitral PVL in 6 cases. This resulted in HF symptom reduction and decreased NT-proBNP plasma concentration. No procedure-related complications occurred.
Conclusions:
Transapical access seems to be an efficient and safe alternative for transvascular approach for mitral TPVLC, but further technical development is still needed.
Related Concept Videos
Mitral Stenosis III: Medical Management
Mitral Regurgitation III: Medical Management
Aneurysm III: Interprofessional Care
Aortic Regurgitation III: Medical Management
Mitral Valve Prolapse III: Nursing Management

