{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:11:01Z","timestamp":1780312261816,"version":"3.54.0"},"reference-count":4,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Paravalvular leak (PVL) is a recognized complication after surgical mitral valve replacement and may cause heart failure, pulmonary hypertension, or hemolysis when moderate or severe. Although redo surgery is the definitive treatment, it carries substantial risk in elderly patients or those with multiple prior cardiac surgeries. Transcatheter PVL closure has therefore emerged as a valuable alternative, albeit with significant technical challenges in the mitral position. We describe the case of a 78\u2010year\u2010old woman with a history of two prior mitral valve replacements using bioprosthetic valves, who presented with progressive dyspnea. Echocardiography demonstrated structural valve degeneration of the mitral bioprosthesis with a large postero\u2010medial mitral PVL causing severe regurgitation. Given the prohibitive surgical risk, percutaneous PVL closure was selected following Heart Team discussion. The procedure was performed under general anesthesia with transesophageal echocardiography and fluoroscopic guidance. An initial antegrade transseptal approach enabled deployment of the first occluder device, but significant residual regurgitation persisted. A second device could not be adequately positioned antegrade and was therefore deployed using a retrograde transaortic approach, which provided improved coaxial alignment. Final imaging showed mild residual regurgitation and a significant reduction in transmitral gradient. The patient had an uneventful recovery with rapid symptomatic improvement and remained clinically stable at 1\u2010month follow\u2010up. This case highlights the feasibility and effectiveness of a hybrid antegrade\u2013retrograde strategy for complex mitral PVL closure and underscores the importance of procedural flexibility and multimodality imaging in achieving optimal outcomes in high\u2010risk patients.<\/jats:p>","DOI":"10.1002\/ccd.70604","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T12:01:46Z","timestamp":1775131306000},"page":"2179-2182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Around and Through: Successful Mitral Paravalvular Leakage Closure Using Both Anterograde and Retrograde Approaches"],"prefix":"10.1002","volume":"107","author":[{"given":"Marco","family":"Garaventa","sequence":"first","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca Nai","family":"Fovino","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Fabris","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8177-2269","authenticated-orcid":false,"given":"Giuseppe","family":"Tarantini","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.16145"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.07.046"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27482"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw579"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70604","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:52:57Z","timestamp":1780311177000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":4,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/ccd.70604"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70604","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]},"assertion":[{"value":"2026-01-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}