Transcatheter Mitral Paravalvular Leak Closure With a Multifunctional Ventricular Septal Defect Occluder

Paravalvular leak (PVL) after surgical mitral valve replacement is an uncommon but clinically significant complication. Redo surgery carries a high risk, making transcatheter closure a viable and less invasive alternative.

We report 2 cases of mitral PVL following prior surgical valve replacement who presented with signs and symptoms of heart failure. After echocardiographic evaluation, a transcatheter approach was undertaken to deploy a Konar-multifunctional (MF) ventricular septal defect (VSD) occluder under fluoroscopic guidance. Following the procedure, both patients showed significant clinical improvement with complete resolution of PVL.

This case series emphasizes the feasibility and favorable outcome of transcatheter closure using the Konar-MF VSD occluder, off-label as an alternative to redo surgery in high-risk surgical patients with mitral PVL. Larger studies are warranted to evaluate the safety and efficacy of this off-label approach across a broader patient population.

New-onset symptoms of heart failure and hemolytic anemia even after years of surgical mitral valve replacement warrant careful and timely evaluation for PVLs. In select high-risk patients who are not ideal candidates for redo surgery, off-label use of the Konar-MF VSD occluder is a feasible alternative for closure of PVLs.