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Resolution of severe hemolysis and paravalvular aortic regurgitation employing an Amplatzer Vascular Plug 4: the importance of detailed pre-procedural planning using CT angiography

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Abstract

A 76-year-old woman presented with progressive heart failure and transfusion-dependent hemolytic anemia due to severe paravalvular aortic regurgitation 4 years after bioprosthetic aortic valve replacement. She was deemed not to be a candidate for redo cardiac surgery due to a porcelain aorta and multiple comorbid medical conditions. We describe the role of pre-procedure contrast-enhanced, ECG-gated computed tomographic angiography to characterize the anatomy of the paravalvular leak connection for appropriate occluder device selection leading to successful percutaneous closure and resolution of the paravalvular regurgitation and hemolytic anemia.

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Authors and Affiliations

  1. Division of Cardiology, Duke University Medical Center, Durham, NC, USA

    Todd L. Kiefer & J. Kevin Harrison

  2. Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    John Vavalle

  3. Division of Radiology, Duke University Medical Center, Durham, NC, USA

    Lynne M. Hurwitz

  4. Division of Cardiac Surgery, Duke University Medical Center, Durham, NC, USA

    G. Chad Hughes

Authors
  1. Todd L. Kiefer
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  2. John Vavalle
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  3. Lynne M. Hurwitz
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  4. G. Chad Hughes
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  5. J. Kevin Harrison
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Corresponding author

Correspondence to Todd L. Kiefer.

Ethics declarations

There are no conflicts of interest for any of the authors. This is a clinical case report and no animals were studied for this case report. Likewise, since this is a clinical case report there was no research informed consent or institutional review board involvement. The patient signed informed consent for the clinical procedure.

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Kiefer, T.L., Vavalle, J., Hurwitz, L.M. et al. Resolution of severe hemolysis and paravalvular aortic regurgitation employing an Amplatzer Vascular Plug 4: the importance of detailed pre-procedural planning using CT angiography. Cardiovasc Interv and Ther 32, 48–52 (2017). https://doi.org/10.1007/s12928-015-0363-z

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  • DOI: https://doi.org/10.1007/s12928-015-0363-z

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