Paravalvular leak is a leak found around the valve replacement and a form of leaky heart valve. When someone undergoes valve replacement surgery, they will have a new valve in place. This valve is usually put in place without any gaps between the valve edges or surrounding heart tissue. Sometimes, there may be gaps left or gaps may develop around your replaced valve which is called paravalvular defects. Blood can leak during these defects which is what you call paravalvular leak. If the leak is significant, it may lead to several symptoms. Paravalvular leak is also what you call perileak, periprosthetic leak and perivalvular leak.

Why can paravalvular leaks occur?

In the case of surgically replacing valves, the valve will be stitched in place by the surgeon. The stitches get loose due to wear and tear and lot of calcium in the heart tissue and the stitches pull through simply. After they become loose, there occurs a paravalvular defect for enabling a paravalvular leak.

In the case of minimally invasive placed valves like the TAVR procedure, valves are generally expanded into place, but sometimes due to the presence of hard pieces of calcium in the heart tissue the valves cannot expand completely. These areas may cause paravalvular defects as well as paravalvular leak.

How long will paravalvular leak happen after the surgery?

Paravalvular leaks take place several years due to wear and tear and after valve replacement surgery. Regretfully, this may sometimes be seen quickly after the surgery due to tissue tearing through the stitches or stitches getting loose. This seems to be frustrating but in the case of TAVR methods, the leak can usually be found right away and when large enough may be taken care of. This will enable patients to leave the operating room without paravalvular leak.

How much paravalvular leak is required to cause the symptoms?

The small Paravalvular leaks won’t cause any symptoms. The exception is there in a condition you call hemolysis where the leaking of blood may cause destruction of red blood cells and anemia due to blood count dropping down to be low. Hemolysis can happen with larger leaks also and paravalvular leaks that seem to be moderate or say, severe can be the reason for symptoms.

What are the signs and symptoms of paravalvular leak?

The common symptom of a significant leak will be heart failure. This may cause heart flutter, shortness of breath, atrial fibrillation, easy fatigue and swelling. Symptoms will generally be worse with daily exercise. Patients might have evidence of Paravalvular leak with heart murmur and fluid retention during the examination.

How can you diagnose paravalvular leak?

Patients who have Paravalvular leak will suffer from heart murmur that can be picked up with a stethoscope. After there is the suspicion for Paravalvular leak, patients will conduct a test called a transthoracic echocardiogram (TTE) which is ultrasound scan of your heart. Paravalvular leaks are usually difficult to diagnose and might not be picked up by transthoracic echocardiogram. There is a test called transesophageal echocardiogram (TEE) used in which a small echocardiogram probe passes down food pipe and obtain higher-resolution images of the heart check up in details. This is the standard way to diagnose Paravalvular leak. When investigating para-valvular leaks, a 3D-TEE will be performed to identify the defect and obtain important information about fixing it.

Is there any medicine for paravalvular leak?

Paravalvular leak is a mechanical problem and patients having these signs and symptoms of heart failure might require diuretics. Diuretics are said to be water tablets that can eliminate excess fluid and improve symptoms until the defect gets fixed. Patients with anemia are related to hemolysis from the defect as blood transfusions are required for symptomatic treatment till the defect gets fixed.

How is it possible to fix paravalvular leak?

Patients have required open-heart surgery repeatedly to fix the problem of paravalvular leaks. But the latest advancements in technology means there are minimally invasive methods to repair these defects which are what you call percutaneous repair of the paravalvular leak.

When it is surgical repair, the procedure will be an open-heart which typically involves the placement of a new valve. The risk is greater due to open-heart surgery and this depends on other factors likee how well the patient is in general.

For minimally invasive percutaneous repair, the defect gets repaired by means of a small tube placed into the artery. The equipment will then be passed up to the heart through these tubes and plugs are placed which obliterate the leak. After performing this procedure, patients with paravalvular leak will be sent home on the next day. Experts are needed in these imaging techniques to perform such a procedure effectively and safely.

There is large paravalvular leak found at the valve’s side where the blood may be seen leaking backwards to the top chamber of your heart. A plug can be seen placed in the leak area which enables to get rid of the paravalvular leak. This plug had been placed without the need to perform open-heart surgery, a method called percutaneous repair. The plug used for fixing paravalvular leak can be seen clearly by the valve’s side where it will be seated nicely without interfering with the valve.

Thus, you may visit the best cardiac hospital in London for your heart checkup and improve overall condition.