Double closure repair of mitral paravalvular leak by way of right thoracotomy.

Paravalvular leak (PVL) occurs in up to 12.5% of mitral valve replacements (MVRs) and sometimes recurs. Although various techniques to repair such leaks have been described, surgical intervention for patients undergoing multiple repeat surgery poses a formidable challenge. For the purposes of good exposure and durable repair of mitral PVL, we describe a double closure technique with pledgeted sutures and a pericardial patch using right thoracotomy. This technique might provide greater durability of the repair site and good exposure of the mitral valve.