Academic Journal
Prison Break: Extraction of a Plug Jailed Between Two Mechanical Valves.
| Τίτλος: | Prison Break: Extraction of a Plug Jailed Between Two Mechanical Valves. |
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| Συγγραφείς: | Chaddad R; Department of Cardiology, Grand Hopital de l'Est Francilien, Jossigny, France., Elhadad S; Department of Cardiology, Grand Hopital de l'Est Francilien, Jossigny, France., Caussin C; Department of Cardiology, Institut Mutualiste Montsouris, Paris, France., Hakim M; Department of Cardiology, Grand Hopital de l'Est Francilien, Jossigny, France., Sfeir M; Department of Cardiology, Institut Mutualiste Montsouris, Paris, France. |
| Πηγή: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2026 Aug; Vol. 108 (2), pp. 596-601. Date of Electronic Publication: 2026 Jun 10. |
| Τύπος έκδοσης: | Case Reports; Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Liss Country of Publication: United States NLM ID: 100884139 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-726X (Electronic) Linking ISSN: 15221946 NLM ISO Abbreviation: Catheter Cardiovasc Interv Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Wiley-Liss, c1999- |
| Ιατρικοί όροι (MeSH): | Foreign-Body Migration*/etiology , Foreign-Body Migration*/therapy , Foreign-Body Migration*/diagnostic imaging , Foreign-Body Migration*/physiopathology , Foreign-Body Migration*/surgery , Heart Valve Prosthesis Implantation*/adverse effects , Heart Valve Prosthesis Implantation*/instrumentation , Device Removal*/methods , Cardiac Catheterization*/instrumentation , Mitral Valve Insufficiency*/etiology , Mitral Valve Insufficiency*/physiopathology , Mitral Valve Insufficiency*/therapy , Mitral Valve Insufficiency*/diagnostic imaging , Mitral Valve Insufficiency*/surgery , Mitral Valve*/surgery , Mitral Valve*/physiopathology , Mitral Valve*/diagnostic imaging , Aortic Valve*/surgery , Aortic Valve*/physiopathology , Aortic Valve*/diagnostic imaging , Heart Valve Prosthesis* , Prosthesis Failure*, Pulmonary Edema/etiology ; Pulmonary Edema/therapy ; Heart Failure/etiology ; Heart Failure/physiopathology ; Humans ; Female ; Adult ; Treatment Outcome ; Prosthesis Design ; Echocardiography, Transesophageal ; Hemodynamics ; Recurrence |
| Περίληψη: | Paravalvular leak (PVL) occurs in up to 17% of prosthetic valve replacements, mainly in the mitral position. Surgery is the gold standard but carries high morbidity in patients with a history of previous sternotomies. Transcatheter closure of PVL offers a minimally invasive alternative with a very high success rate. Device migration, while uncommon, can be catastrophic when impinging on mechanical prosthetic valve performance. We report the case of a 37-year-old woman with prior mechanical mitral and aortic valve replacements, complicated by recurrent heart failure due to a mitral PVL resulting from suture dehiscence. Initial transcatheter closure with two Amplatzer Vascular Plug III devices achieved a substantial reduction of regurgitation. Four months later, she presented with acute pulmonary edema caused by migration of one device into the left ventricular outflow tract, intermittently obstructing a mechanical aortic valve leaflet. Given her prohibitive surgical risk, percutaneous retrieval was undertaken, followed by immediate re-closure of the PVL during the same procedure, successfully restoring valve function and hemodynamic stability. This case illustrates the complexity of late PVL management after mechanical mitral valve replacement and highlights the potential risk of device migration. While surgery remains the gold standard, percutaneous intervention represents the only viable option in patients at prohibitive surgical risk. To our knowledge, this is the first reported case of successful percutaneous retrieval of an embolized device through a mechanical prosthesis, followed by re-closure of the PVL within the same procedure. This experience underscores the feasibility of advanced bailout strategies in carefully selected patients. (© 2026 Wiley Periodicals LLC.) |
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| Entry Date(s): | Date Created: 20260610 Date Completed: 20260803 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13432656 |
| DOI: | 10.1002/ccd.70686 |
| PMID: | 42271187 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1522-726X |
|---|---|
| DOI: | 10.1002/ccd.70686 |