Successful Treatment of Severe Paravalvular Leak by Repositioning a Self-Expandable Percutaneous Aortic Valve Bioprosthesis (Evolut PRO+) Using the “Double Snare” Technique

Figure 7

Transesophageal echocardiogram after valve repositioning. Mild PVL by color Doppler (arrow) in the (a) short-axis and (b) deep-transgastric views (Videos 4 and 5). (c) PVL circumferential extent (arrow) was reduced to 20%. (d) Long-axis view showing mild PVL (arrow). (e) Severe PVL (arrow) prior to valve repositioning for comparison. Postrepositioning, the aortic annulus-to-valve inflow distance (braces) was reduced from (e) 3.0 cm to (d) 1.3 cm.

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