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

Abstract

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.

Keywords: arterial‐arterial rail technique; paravalvular leakage; transcatheter aortic valve implantations.