Use of radial access to create an arterio-arterial loop to facilitate the percutaneous closure of paravalvular aortic leak. Is it feasible?

Abstract

To the Editor, Transcatheter paravalvular leak (PVL) closure through the implantation of occlusion devices has become an alternative to surgery.1 The closure of aortic PVLs is usually performed through retrograde approach (via femoral artery and with echocardiographic and fluoroscopic guidance).2 There are times that the antegrade approach is necessary (via femoral vein through transseptal puncture, rarely transapical approach). However, certain cases require additional support using an arteriovenous loop. This is often done through the snaring of a wire introduced into the left atrium with a catheter that is advanced through the interatrial septum (transseptal).3-4 We describe a non-reported approach so far: the transcatheter closure of paravalvular leak using an arterio-arterial loop by passing the wire through the bioprosthesis and using radial access to snare the wire.