{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:57:06Z","timestamp":1785776226816,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Paravalvular leak (PVL) occurs in up to 17% of prosthetic valve replacements, mainly in the mitral position. Surgery is the gold standard but carries high morbidity in patients with a history of previous sternotomies. Transcatheter closure of PVL offers a minimally invasive alternative with a very high success rate. Device migration, while uncommon, can be catastrophic when impinging on mechanical prosthetic valve performance. We report the case of a 37\u2010year\u2010old woman with prior mechanical mitral and aortic valve replacements, complicated by recurrent heart failure due to a mitral PVL resulting from suture dehiscence. Initial transcatheter closure with two Amplatzer Vascular Plug III devices achieved a substantial reduction of regurgitation. Four months later, she presented with acute pulmonary edema caused by migration of one device into the left ventricular outflow tract, intermittently obstructing a mechanical aortic valve leaflet. Given her prohibitive surgical risk, percutaneous retrieval was undertaken, followed by immediate re\u2010closure of the PVL during the same procedure, successfully restoring valve function and hemodynamic stability. This case illustrates the complexity of late PVL management after mechanical mitral valve replacement and highlights the potential risk of device migration. While surgery remains the gold standard, percutaneous intervention represents the only viable option in patients at prohibitive surgical risk. To our knowledge, this is the first reported case of successful percutaneous retrieval of an embolized device through a mechanical prosthesis, followed by re\u2010closure of the PVL within the same procedure. This experience underscores the feasibility of advanced bailout strategies in carefully selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70686","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T03:50:32Z","timestamp":1781149832000},"page":"596-601","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prison Break: Extraction of a Plug Jailed Between Two Mechanical Valves"],"prefix":"10.1002","volume":"108","author":[{"given":"Rima","family":"Chaddad","sequence":"first","affiliation":[{"name":"Department of Cardiology Grand Hopital de l'Est Francilien Jossigny France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Elhadad","sequence":"additional","affiliation":[{"name":"Department of Cardiology Grand Hopital de l'Est Francilien Jossigny France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Caussin","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institut Mutualiste Montsouris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maher","family":"Hakim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Grand Hopital de l'Est Francilien Jossigny France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8374-6822","authenticated-orcid":false,"given":"Maroun","family":"Sfeir","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institut Mutualiste Montsouris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.11.1316"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.09.019"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.03.104"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.08.033"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.11.1316"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00358-9"},{"key":"e_1_2_8_9_1","first-page":"Q47","article-title":"Transcatheter Aortic Valve Replacement for Degenerative Surgical Bioprosthetic Valves and Paravalvular Leak: Review and Clinical Recommendations","volume":"8","author":"Dvir D.","year":"2012","journal-title":"EuroIntervention"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.778886"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2010.04.013"},{"issue":"6","key":"e_1_2_8_12_1","first-page":"450","article-title":"Usefulness of Transesophageal Echocardiography for Diagnosis of Hemolysis After Prosthetic Valve Replacement","volume":"73","author":"Cort\u00e9s M.","year":"1994","journal-title":"American Journal of Cardiology"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"issue":"7","key":"e_1_2_8_14_1","first-page":"589","article-title":"Role of Real\u2010Time 3D Transesophageal Echocardiography in the Assessment of Paravalvular Leaks","volume":"13","author":"Faletra F. F.","year":"2012","journal-title":"European Heart Journal Cardiovascular Imaging"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.03.074"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21270"},{"issue":"4","key":"e_1_2_8_17_1","first-page":"1239","article-title":"Surgical Treatment of Paravalvular Leaks: Long\u2010Term Results in a Large Series of Patients","volume":"99","author":"Taramasso M.","year":"2015","journal-title":"Annals of Thoracic Surgery"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-19-00517"},{"issue":"9","key":"e_1_2_8_19_1","first-page":"1103","article-title":"Paravalvular Leak Closure: State of the Art","volume":"12","author":"Garc\u00eda E.","year":"2016","journal-title":"EuroIntervention"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022684"},{"issue":"19","key":"e_1_2_8_21_1","first-page":"1945","article-title":"Device Embolization in Structural Heart Interventions: Incidence, Outcomes, and Retrieval Techniques","volume":"10","author":"Alkhouli M.","year":"2017","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"2","key":"e_1_2_8_22_1","first-page":"E60","article-title":"Retrieval of Embolized Amplatzer Vascular Plugs","volume":"86","author":"Brener M. 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