{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:35:56Z","timestamp":1773920156753,"version":"3.50.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mitral paravalvular leak (PVL) is a recognized complication following prosthetic valve replacement, associated with heart failure, hemolysis, and increased morbidity. While redo surgery is the traditional treatment, transcatheter closure has emerged as a less invasive alternative, particularly in high-risk surgical candidates. Here, we present a case of preoperative FluoroCT imaging planning for transapical closure of mitral PVL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 57-year-old female with prior double mechanical valve replacement (mitral and aortic) presented with worsening exertional dyspnea and fatigue.Transesophageal Echocardiography (TEE) identified a 5\u2005mm posterior paravalvular leak adjacent to the mitral sewing ring. Preoperative contrast-enhanced CT analyzed with FluoroCT imaging software localized the leak to the 4\u20135 o'clock position and provided the optimal C-arm projection (cranial 48\u00b0, left anterior oblique 8\u00b0). Transapical closure via a left mini-thoracotomy was performed, and a 10\u2005mm Ventricular Septal Defect occluder (Huayishengjie Medical Company, Beijing, China) was successfully deployed under TEE and fluoroscopic guidance. The patient had no residual leak, and total procedure time was 1\u2005hour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FluroCT imaging-guided preoperative CT planning enables accurate localization of PVL and optimal fluoroscopic projection, reducing procedure time and improving safety. Transapical closure remains a feasible and effective approach for posterior mitral PVL in complex double-valve patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1764024","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:47:53Z","timestamp":1773902873000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative FluoroCT imaging -guided transapical closure of mitral paravalvular leak: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Qiong","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Cardiology, Chongqing General Hospital, Chongqing University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Chongqing General Hospital, Chongqing University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongkun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Chongqing General Hospital, Chongqing University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Chongqing General Hospital, Chongqing University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.3390\/jcm11051245","article-title":"Mitral paravalvular leak: clinical implications, diagnosis and management","volume":"11","author":"Cruz-Gonzalez","year":"2022","journal-title":"J Clin 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College of Cardiology (ACC), the European Society of Cardiovascular Radiology (ESCR), the North American Society of Cardiovascular Imaging (NASCI), the Radiological Society of North America (RSNA), the Society for Cardiovascular Angiography & Interventions (SCAI) and Society of Thoracic Surgeons (STS)","volume":"86","author":"Budde","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.1016\/j.jcmg.2020.12.034","article-title":"Computed tomography-derived 3D modeling to guide sizing and planning of transcatheter mitral valve interventions","volume":"14","author":"Ooms","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"B9","doi-asserted-by":"publisher","first-page":"582925","DOI":"10.3389\/fcvm.2021.582925","article-title":"Multimodality cardiac imaging for procedural planning and guidance of transcatheter mitral valve replacement and mitral paravalvular leak 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