An artist illustration for a novel technique of repair of mitral paravalvular leak: (A) if the leak is located towards the interatrial septum, (B) it can be approached from the right atrial side of the interatrial septum and (C) being aware of the location of the conduction bundle and atrioventricular node (yellow colour in the illustration) to provide more secure repair. Another technical strategy for the leak that is located at the aortomitral curtain (D), sutures can be placed through an aortotomy and after retraction of the aortic leaflets (E), the pledgeted sutures pass below the aortic annulus into the mitral prosthesis sewing ring (F) and the pledgets can be seen below the aortic valves cusps (G).