**8. Wrap-up**

Essential steps forward TPVL achievement begin with a clinical suspicion that should include heart failure, anemia, infection, and equivalent syndromes. TTE should be very large. Multimodality imaging assessment is encouraged and facilitates the localization, anatomy evaluation, and measurement of the PVLs, and it prepares and guides the closure intervention. Full patient assessment is also needed, including comorbidities, frailty. Indication should be led by a structural valve specialized heart team. The patient's preferences are taken into account. The planification of intervention is precise and demands a large material set preparation to be able to adapt the technique and address complications, and can miss the diagnosis, particularly in the case of mitral PVL. The procedure is conducted in expertise centers. A long-term close follow-up is then needed as complications can occur at any time of the evolution.
