RHYME AND REASON FOR THE BAD RHYTHM: TRIPLE TROUBLE; 1. MITRAL PARAVALVULAR LEAK; 2. CONSTRICTIVE PERICARDITIS; 3. RESISTANT ATRIAL FIBRILLATION

Constrictive pericarditis after catheter ablation for atrial fibrillation.

A 70-year-old man with paroxysmal atrial fibrillation was referred for pulmonary vein isolation. Past medical history included ischemic heart disease and a right hemicolectomy for Duke’s C carcinoma 10 years previously. Presenting ECG showed sinus rhythm with a normal axis and evidence of left atrial enlargement (Figure 1). Preoperative echocardiography demonstrated normal left ventricular stru...

Percutaneous closure of mitral paravalvular leak.

Paravalvular leak (PVL) is a complication observed in patients after prosthetic valve replacement. The incidence of PVL is estimated as 2-3%. The cause of PVL may be paravalvular infection, suture continuity disruption, damage of tissues around the annulus or limitation of disc mobility by thrombus or vegetation. The preferable method of treatment of PVL is surgery. Recently, percutaneous closu...

Percutaneous Closure of Mitral Paravalvular Leak

MTSAC Full Member of Sociedad Argentina de Cardiología 1 Service of Interventional Cardiology and Endovascular Therapeutics, Instituto Cardiovascular de Buenos Aires (ICBA). Buenos Aires, Argentina 2 Service of Cardiovascular Surgery, Instituto Cardiovascular de Buenos Aires (ICBA). Buenos Aires, Argentina 3 Service of Diagnostic Imaging, Instituto Cardiovascular de Buenos Aires (ICBA). Buenos ...

Transapical closure of mitral prosthetic paravalvular leak.

Clinically significant mitral prosthetic paravalvular leaks may occur in up to 5% of patients following surgical mitral valve replacement. Successful closure may offer relief from symptoms of heart failure and hemolysis, but surgical closure is associated with increased morbidity and mortality. Alternative transcatheter closure techniques are being developed. We present a patient who was succes...

Atrial fibrillation begets trouble.