Catheter-based Closure of a Post-infective Aortic Paravalvular Pseudoaneurysm Fistula With Severe Regurgitation After Two Valve Replacement Surgeries: A Case Report

Backgsround: Infective endocarditis (IE) of prosthetic valves is a dire complication cardiac valve replacement surgery and associated with high rates morbidity mortality. Case Summary: A 72-year-old woman multiple comorbidities underwent surgical the aortic mechanical after recurrent IE. After 10 years, IE recurred was surgically replaced bioprosthetic valve. Ten years later, severe heart failure developed due to paravalvular leak (PVL) caused by an annulus abscess complicated pseudoaneurysm fistula (PPF). The patient deemed at prohibitive risk catheter-based PVL closure procedure planned. However, interventional delayed several months Covid-19 pandemic progressive worsening. Despite acute satisfactory result PPF transcatheter significant clinical improvement, died later multiorgan failure. It likely that this due, least in part, long treatment delay unprecedented strain on healthcare system. Discussion: In patients risk, early diagnosis prompt are crucial for improving expectancy quality life. recent outbreak COVID-19 deferral elective semi-elective structural disease procedures (SHD) as our case. Thus, proactive vigilant stance managing SHD should be priority even context pandemic.