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Ann Thorac Surg 2009;88:1327-1329. doi:10.1016/j.athoracsur.2009.02.054
© 2009 The Society of Thoracic Surgeons
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Santiago Serrano-Fiz
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Case Reports

Failure of Percutaneous Closure of Prosthetic, Aortic Paravalvular Leak

Evaristo Castedo, MD*, Santiago Serrano-Fiz, MD, Juan F. Oteo, MD, Sebastian Ramis, MD, Paloma Martinez, MD, Juan Ugarte, MD

Department of Cardiothoracic Surgery, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autonoma de Madrid, Madrid, Spain

Accepted for publication February 17, 2009.

* Address correspondence to Dr Castedo, Department of Cardiothoracic Surgery, Hospital Universitario Puerta de Hierro Majadahonda, Manuel de Falla 1, Majadahonda, 28222, Spain (Email: evaristocm{at}terra.es).

We report the progression of aortic insufficiency after percutaneous closure of an aortic prosthesis paravalvular leak with the Amplatzer vascular plug (AGA Inc, Golden Valley, MN). Removal of the device and replacement of the aortic prosthesis was successfully performed. Based on operative findings, we hypothesize that shape mismatch between the occluder system and the leak might promote tearing at the end of slanted defects further enhancing the regurgitant area.






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