When Echocardiography Is Challenging in Localizing Bioprosthetic Aortic Regurgitation

Abstract

Transesophageal echocardiography is the main imaging modality for localizing and quantifying prosthetic aortic regurgitation. We describe a case of bioprosthetic aortic paravalvular leak (PVL) where transesophageal echocardiography was inadequate; aortic root angiography and computed tomography fusion were critical in diagnosing and guiding closure. Multimodality imaging can be pivotal in localizing PVL and guiding transcatheter PVL closure. (Level of Difficulty: Intermediate.)

Keywords

• aortic angiography
• CT fusion
• multimodality imaging
• paravalvular leak