Transcatheter Mitral and Aortic Paravalvular Leak Closure: Innovations, Challenges, and Future Directions
Year: 2026
Type: article
Abstract: Paravalvular leak (PVL) is a well-known complication of valve replacement, occurring in up to 10% of aortic and 17% of mitral prosthetic valves. Although many leaks are small and clinically insignificant, ≈1% to 5% of cases are associated with clinically relevant complications, such as heart failure symptoms and hemolytic anemia. Surgical reoperation is currently considered the first-line option; however, it encompasses high mortality and morbidity risks. In the past years, transcatheter PVL closure has proven to be highly effective when performed in experienced centers. Transcatheter PVL closure requires advanced imaging modalities, specialized materials, and techniques, reflecting the high complexity of the procedure. We review the complex nature of PVL, including its diagnostic workup and the available transcatheter treatment strategies, with a special focus on the treatment of mitral and aortic PVL using plugging devices.
Authors: Andrea Ruberti, Eduardo Flores-Umanzor, Laura Sanchis, Thomas Pilgrim, Ander Regueiro, Philippe Garot, Reda Ibrahim, Guillermo Velazquez, Grzegorz Smolka, Omar Abdul-Jawad Altisent, Pedro Cepas-Guillén, Sebastien Hascoët, Giovanni Occhipinti, Ignacio Cruz-Gonzalez, Marta Sitges, Barbara Vidal, Gerard Martí-Aguasca, Eustaquio Maria Onorato, Mark Osten, Josep Rodes-Cabau, Gabor G. Toth, Nicolas Dumonteil, Patrick A. Calvert, Eric Horlick, Xavier Freixa
Institutions: Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, University of Bern, University Hospital of Bern, Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Montreal Heart Institute, Université de Montréal, Medical University of Silesia, Inserm, Université Paris-Saclay, Hôpital Marie Lannelongue, Hôpital Paris Saint-Joseph, Instituto de Investigación Biomédica de Salamanca, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, IRCCS Ospedale Galeazzi - Sant'Ambrogio, University Health Network, Toronto General Hospital, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Medical University of Graz, Clinique Pasteur, University of Cambridge, Royal Papworth Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7130508222