Successful Closure of Paravalvular Leak Using Computed Tomography Image Fusion and Planning With 3-Dimensional Printing

Abstract

The presence of moderate to severe paravalvular leak increases mortality. We present a case of giant paravalvular leak closure using the 3-dimensional printing model to assess the success of the device to be used for its closure, computed tomography was performed for planning and guiding the procedure by image fusion. ( Level of Difficulty: Advanced. )

Computed Tomography/Fluoroscopy Fusion and 3D Transesophageal Echocardiography-Guided Percutaneous Paravalvular Leak Closure

“…Although TOE remains mandatory for transseptal puncture and reassessing PVL measures during the procedure, CT scan/fluoroscopy fusion guidance is an interesting tool to facilitate PVL crossing because it enables accurate on-screen PVL visualization. 5 Indeed, especially for aortic PVL, TOE guidance alone for this critical step might provide insufficient insight. Even though TOE guidance usually enables correct visualization of mitral PVL, fusion guidance can still be useful in this case to guide the device implantation directly on the fluoroscopy screen.…”

Procedural Tools and Technics for Transcatheter Paravalvular Leak Closure: Lessons from a Decade of Experience

“…Some experts reported occasionally using fluoroscopy alone for aortic tPVLc. Fusing echocardiography or CT with fluoroscopy was increasingly used [14,[20][21][22][23][24][25].…”