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Transcatheter Mitral and Aortic Paravalvular Leak Closure: Innovations, Challenges, and Future Directions.
Andrea Ruberti1,2,3, Eduardo Flores-Umanzor1,2,3, Laura Sanchis1,2,3
1Department of Cardiology, Cardiovascular Institute, Hospital Clínic, Barcelona, Spain (A. Ruberti, E.F.-U., L.S., A. Regueiro, G.V., O.A.-J.A., P.C.-G., G.O., M.S., B.V., X.F.).
Circulation. Cardiovascular Interventions
|February 19, 2026
Summary
Paravalvular leak (PVL) is a complication of prosthetic valves. Transcatheter PVL closure offers an effective, less invasive treatment option for significant leaks compared to reoperation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Paravalvular leak (PVL) is a complication of prosthetic valves, affecting up to 10% of aortic and 17% of mitral valves.
- While often small, 1-5% of PVLs cause significant complications like heart failure and hemolytic anemia.
- Surgical reoperation carries high risks, prompting the search for alternative treatments.
Purpose of the Study:
- To review the complex nature of paravalvular leaks.
- To discuss diagnostic workup for PVL.
- To explore transcatheter PVL closure strategies, focusing on plugging devices for mitral and aortic PVL.
Main Methods:
- Review of existing literature on paravalvular leak diagnosis and treatment.
- Focus on transcatheter closure techniques and devices.
- Analysis of outcomes for transcatheter PVL closure in experienced centers.
Main Results:
- Transcatheter PVL closure is effective in experienced centers.
- The procedure requires advanced imaging, specialized materials, and techniques due to its complexity.
- Plugging devices are a key strategy for transcatheter closure of mitral and aortic PVL.
Conclusions:
- Transcatheter PVL closure is a viable and effective alternative to high-risk surgical reoperation.
- Advanced imaging and specialized techniques are crucial for successful transcatheter PVL closure.
- Further research and center experience are vital for optimizing transcatheter PVL treatment strategies.
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