Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Found 1 result for Mr. fabien doguet[Author]
Your search for Mr. Fabien Gonguet[Author] retrieved no results.
Filters applied. Clear all
Case Reports
. 2022 Dec 1;5:101690.
doi: 10.1016/j.jaccas.2022.101690. eCollection 2023 Jan 4.

Computed Tomography/Fluoroscopy Fusion and 3D Transesophageal Echocardiography-Guided Percutaneous Paravalvular Leak Closure

Sandra Zendjebil  1 , Livio d'Angelo  1 , Fabien Doguet  1 , Nicolas Dumont  2 , Hakim Benamer  1 , Dominique Fourchy  1 , Morad Djebbar  1 , Jérome Garot  1 , Régis Vaillant  3 , Philippe Garot  1
Affiliations
Free PMC article
Case Reports

Computed Tomography/Fluoroscopy Fusion and 3D Transesophageal Echocardiography-Guided Percutaneous Paravalvular Leak Closure

Sandra Zendjebil et al. JACC Case Rep. .
Free PMC article

Abstract

Percutaneous paravalvular leak closure seems a safe alternative to surgery in frail patients. However, it is a challenging procedure that should be tailored to each patient with optimal imaging guidance. Transesophageal echocardiography during the procedure and computed tomography scan/fluoroscopy fusion provide guidance for critical steps, such as PVL localization and crossing. (Level of Difficulty: Advanced.).

Keywords: CT; CT, computed tomography; PVL; PVL, paravalvular leak; TEE; TOE, transesophageal echocardiography; closure; fusion; percutaneous.

Conflict of interest statement

This research received no specific grant from any funding agency. Dr Zendjebil has received a research grant from Fédération Française de Cardiologie outside of this work. Mr Dumont is an employee of Abbott Vascular. Mr Vaillant is an employee of General Electric Health Care. Dr Garot is the medical director and a shareholder of CERC. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Preprocedural X Plane Transesophageal Echocardiography Severe anterior and lateral mitral paravalvular leak (diameter 6.3 × 5.4 mm)
Figure 2
Figure 2
Preprocedural 3D Transesophageal Echocardiography Severe anterior and lateral mitral paravalvular leak with higher dimensions after 3-dimensional (3D) transesophageal echocardiography assessment (diameter 6 × 11 mm). 2D = 2-dimensional.
Figure 3
Figure 3
Preprocedural Computed Tomography Scan Severe anterior and lateral mitral paravalvular leak.
Figure 4
Figure 4
Procedural Computed Tomography Scan/Fluoroscopy Fusion The plug is positioned inside the paravalvular leak orifice with computed tomography scan/fluoroscopy fusion (paravalvular leak orifice is represented in green; yellow circle represents the fossa ovalis).
Figure 5
Figure 5
Plug Device Used in Both Procedures
Figure 6
Figure 6
Final 3D Transesophageal Echocardiography Correct occlusion of the paravalvular leak with the plug. 2D = 2-dimensional; 3D = 3-dimensional.
Figure 7
Figure 7
Final X Plane Transesophageal Echocardiography Correct occlusion of the paravalvular leak with the plug.
Figure 8
Figure 8
Preprocedural Transesophageal Echocardiography Severe anterior paravalvular leak around the aortic biological prosthesis.
Figure 9
Figure 9
Preprocedural Computed Tomography Scan Anterior 5-mm-wide paravalvular leak around the aortic biological prosthesis.
Figure 10
Figure 10
Prosthesis Mesh Crossing Demonstration Selection of the right prosthesis mesh to cross with the delivery sheath to access the paravalvular leak around the biological prosthesis.
Figure 11
Figure 11
Procedural Computed Tomography Scan/Fluoroscopy Fusion Paravalvular leak orifice (green line) and the targeted mesh (blue line) to cross to align the delivery sheath with the paravalvular leak. The left main mark (pink line) is useful to avoid conflict with the left main.
Figure 12
Figure 12
Final Transesophageal Echocardiography Reduction of the aortic paravalvular leak.
Figure 13
Figure 13
Preprocedural and Final Cardiac Magnetic Resonance Measured Paravalvular Leak Aortic Flow Reduction of the aortic paravalvular leak with a reduction of the regurgitated fraction (RF) from 41% to 8%.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Garg A., Azad S., Radhakrishnan S. Percutaneous paravalvular leak closure with their outcomes: A single center experience. Ann Card Anaesth. 2021;24(3):302–307. doi: 10.4103/aca.ACA_157_20. - DOI - PMC - PubMed
    1. Cruz-Gonzalez I., Rama-Merchan J.C., Arribas-Jimenez A., et al. Paravalvular leak closure with the Amplatzer Vascular Plug III device: immediate and short-term results. Rev Esp Cardiol (Engl Ed) 2014;67(8):608–614. doi: 10.1016/j.rec.2013.09.031. - DOI - PubMed
    1. Smolka G., Pysz P., Jasiński M., et al. Multiplug paravalvular leak closure using Amplatzer Vascular Plugs III: A prospective registry. Catheter Cardiovasc Interv. 2016;87(3):478–487. doi: 10.1002/ccd.25992. - DOI - PubMed
    1. Malahfji M.C.S., Faza N., Chinnadurai P., et al. Clinical utility of CT fusion imaging in guiding transcatheter paravalvular leak closure. J Am Coll Cardiol. 2019;73(Suppl 1):1196. doi: 10.1016/S0735-1097(19)31803-0. - DOI
    1. Espinoza Rueda M.A., Alcántara Meléndez M.A., González R.M., et al. Successful closure of paravalvular leak using computed tomography image fusion and planning with 3-dimensional printing. J Am Coll Cardiol Case Rep. 2021;4(1):36–41. doi: 10.1016/j.jaccas.2021.08.017. - DOI - PMC - PubMed

Publication types

LinkOut - more resources