Transcatheter closure of paravalvular leak after Bentall surgery in a Marfan patient: a rare case report

TL;DR

A rare case of paravalvular leak after heart surgery in a Marfan patient was successfully treated with a transcatheter closure.

Contribution

This case report presents a rare and successful transcatheter treatment of paravalvular leak in a Marfan patient post-Bentall surgery.

Findings

A 38-year-old Marfan patient developed a paravalvular leak three months after Bentall surgery.

Transcatheter closure using a symmetric VSD occluder resolved the leak and improved heart failure symptoms.

Post-procedural imaging showed near-complete leak resolution and reduced pseudoaneurysm size.

Abstract

Paravalvular leak (PVL) following Bentall surgery in patients with Marfan syndrome is exceedingly rare. A 38-year-old Marfan patient underwent Bentall + Sun's procedure for Stanford type A aortic dissection with severe aortic regurgitation. On the third month after surgery, the patient was readmitted due to exertional dyspnea. Echocardiography revealed a paravalvular leak with significant left-to-right shunting, leading to symptoms including exertional dyspnea, hepatomegaly, and heart failure. After adequate preparation, the leak was successfully closed using a symmetric VSD occluder. Post-procedural imaging showed near-complete resolution of the leak, significant reduction in the pseudoaneurysm size, and improvement in heart failure symptoms. The patient was discharged in stable condition.

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