Images in cardiologyPercutaneous aortic leak closure in a small and frail annulus after double heart valve replacementSaitto, Guglielmoa; Nardi, Paoloa; Ussia, Gian P.b; Sergi, Domenicob; Prati, Paoloc; Russo, Marcoa; Romeo, Francescob; Ruvolo, GiovanniaAuthor Information aCardiac Surgery Unit bCardiology Unit cCardiac Anesthesia Division, Tor Vergata University Policlinic, Rome, Italy Correspondence to Guglielmo Saitto, MD, Cardiac Surgery Division, Tor Vergata University Policlinic, Viale Oxford 81, 00133 Rome, Italy Tel: +39 3333998175; e-mail: [email protected] Received 14 June, 2017 Revised 28 July, 2017 Accepted 22 August, 2017 Journal of Cardiovascular Medicine: November 2017 - Volume 18 - Issue 11 - p 916-919 doi: 10.2459/JCM.0000000000000571 Buy Metrics Abstract Paravalvular leak (PVL) is an uncommon but serious complication associated with the implantation of prosthetic valves. Following aortic valve replacement, up to 5% of patients affected by PVL develop clinical symptoms of heart failure, hemolysis or both. Percutaneous treatment of PVL has emerged instead of conventional surgery, as a well tolerated and less invasive procedure but remains a challenge. We present the case of a young woman with mechanical aortic and mitral prostheses, who presented surgical aortic PVL caused by a serious frailty of native annulus, became symptomatic after 5 months and was successfully percutaneously treated with an Amplatzer Duct Occluder device. © 2017 Italian Federation of Cardiology. All rights reserved.