Retrieval of an embolised occluder with an alligator forceps during staged paravalvular leakage closure

  • Karsten LenkEmail author
  • Andreas Hagendorff
  • Ulrich Laufs
  • Ingo Dähnert
Letter to the Editors


A 54-year-old male with a history of three previous cardiac surgical interventions presented with progressive dyspnoea, NYHA Class IV and rapid weight gain of 15 kg during the last 10 weeks. In 2010, he underwent aortic valve replacement due to native valve endocarditis. Two years later he suffered from prosthetic valve endocarditis and a redo aortic valve replacement had to be performed. In 2017 the patient had recurrent prosthetic valve endocarditis this time involving the mitral valve. It was complicated by an aortic aneurysm with aortic valve regurgitation and severe mitral regurgitation. He underwent mitral valve replacement (Mosaic® 29 mm; Medtronic inc.) combined with re-redo aortic valve replacement (Carpentier-Edwards Perimount Magna Ease® 25 mm, Edwards Lifesciences), reconstruction of the aorto-mitral continuity and root replacement. His relevant comorbidities comprised of chronic obstructive pulmonary disease, chronic kidney disease stage 3, diabetes mellitus type 2...


Compliance with ethical standards

Conflict of interest

Ingo Dähnert is a proctor for Abbott Amplatzer Occlusion devices.

Informed consent

The author/s confirm that written consent for submission and publication of this case report including image(s) and associated text has been obtained from the patient in line with COPE guidance.

Supplementary material

392_2019_1419_MOESM1_ESM.m4v (174 kb)
ESM 1: 2D and Color Doppler Echo showing a severe paravalvular mitral valve defect (M4V 173 KB)
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ESM 2: 3D Echo demonstrating the paravalvular crescent defect of the mitral valve prosthesis (M4V 175 KB)
392_2019_1419_MOESM3_ESM.m4v (128 kb)
ESM 3: 2D Echo showing the dislocated Amplatzer Duct Occluder in the Left Ventricle (M4V 128 KB)
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ESM 4: Fluoroscopy showing the dislocated Amplatzer Duct Occluder in the Left Ventricle (M4V 1019 KB)
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ESM 5: Fluoroscopy searching for the dislocated Amplatzer Duct Occluder (M4V 1841 KB)
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ESM 6: Fluoroscopy after positioning the second Amplatzer Vascular Plug 3 (M4V 329 KB)
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ESM 7: 2D Echo demonstrating the final result with no relevant paravalvular regurgitation (M4V 253 KB)
392_2019_1419_MOESM8_ESM.m4v (262 kb)
ESM 8: 3D Echo showing the two Amplatzer Vascular Plug 3 (M4V 261 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik und Poliklinik für KardiologieUniversitätsklinikum LeipzigLeipzigGermany
  2. 2.Herzzentrum Leipzig, Universitätsklinik für KinderkardiologieLeipzigGermany

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