Percutaneous Transapical Closure of Mitral Paravalvular Leak in the Immediate Postoperative Period

An 83-year-old male with a history of atrial fibrillation, peripheral vascular disease, Type 3 chronic kidney disease, and rheumatoid arthritis underwent a tissue mitral valve (MV) replacement for severe primary mitral regurgitation (MR) and impaired left ventricular (LV) function (ejection fraction 40%). He was progressing well postoperatively until day 8, when he developed New York Heart Association Class IV heart failure and a loud PSM was heard.