Heart valve diseases account for a significant portion of hospitalizations due to cardiovascular diseases in Brazil. Prosthetic heart valves, which are often part of treatment, are susceptible to complications, such as paravalvular leak. Surgical intervention remains the treatment of choice for correcting this defect. However, transesophageal echocardiography-guided catheter correction has emerged as a less invasive alternative for paravalvular leak treatment in patients at high surgical risk. We report a case of extensive mitral paravalvular leak in a patient who had two previous cardiac surgeries and a high surgical risk, who underwent successful transcatheter closure with three prosthesis implantation by transapical access.
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