‘Full-metal Jacket’ treatment of multiple paravalvular leaks

UNASSIGNED A 40-year-old man with osteogenesis imperfecta type I submitted to multiple procedures of surgical mitral and aortic valve replacement was referred for refractory congestive heart failure due to significant paravalvular leaks (PVLs) of both mitral and aortic prostheses. Due to perceived very high risk of a further mitroaortic surgery, transcatheter closure of PVLs under three-dimensional echocardiographic guide was performed. Thus, four Amplatzer Vascular Plug type II (St. Jude Medical Corp, St. Paul, Minnesota, USA) devices were implanted into the aortic PVLs, and three Amplatzer Vascular Plug type II devices were used to occlude a huge mitral PVL. The procedure was performed in two-step, 7-day apart approach, and the patient was discharged after 2 weeks. Over a midterm follow-up, clinical and instrumental findings significantly improved resulting in weaning from pharmacologic therapy.