Paravalvular leak closure after TAVI with plugs: A literature review with a specific focus on arterio-arterial loop.

Flores-Umanzor, Eduardo; Cepas-Guillén, Pedro; Ruberti, Andrea; Regueiro, Ander; Sanchis, Laura; Gabani, Rami; Rodés-Cabau, Josep; Vidal, Barbara; Freixa, Xavier (2024). Paravalvular leak closure after TAVI with plugs: A literature review with a specific focus on arterio-arterial loop. (In Press). Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions Wiley 10.1002/ccd.31145

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More than mild paravalvular leak (PVL) following transcatheter aortic valve implantation (TAVI) is associated with a twofold increase in all-cause mortality, heart failure hospitalizations, and the need for reintervention. Successfully addressing PVL in TAVIs is more challenging than in surgical valves. The arterial-arterial (A-A) rail technique emerges as a valuable strategy for post-TAVI PVL closure, enhancing success rates by enabling the effective use of lower-profile vascular plug devices. When standard approach is ineffective, generating an A-A loop for post-TAVI PVL closure is probably the most recommended strategy to ensure procedural success.

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