Atrial Back Wall Support to Facilitate Antegrade Closure of Complex Mitral Paravalvular Leaks.

Transapical puncture for transcatheter treatment of mitral-paravalvular leak (PVL) is associated with increased risks even when the apical tract is closed with vascular plugs. A novel technique that leverages back wall support from the right or left atrium can be used to facilitate transcatheter closure of mitral PVL through an antegrade approach. ( Level of Difficulty: Advanced. ).