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. 2022 Apr 1;11(7):1978. doi: 10.3390/jcm11071978

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© 2022 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Upper panel: baseline 2D Transesophageal Echocardiogram (TEE) color Doppler showing a severe paravalvular leak (PVL) regurgitant jet into the left atrium (A) and 3D TEE showing a huge, 20 × 9 mm in diameter, crescent-shaped, antero-laterally located (7–10 o’clock) mitral PVL after bileaflet mechanical valve replacement (B). Lower panel: post-procedure 2D TEE color Doppler showing the correct position of the device (C, yellow arrow) with a trace-mild residual regurgitant jet (C, small white arrow) and 3D TEE confirming the stable position of the 16 × 8 mm-rectangular waist PLD (yellow arrow), without impingement on the mechanical prosthetic mitral valve (D). LA, left atrium; LV, left ventricle; PLD, Occlutech Paravalvular Leak Device; RW, rectangular waist.