What is a Paravalvular Leak Closure?
A Paravalvular Leak is a rare complication in the surgical treatment of valve disease. Leaks can emerge over time or be an acute occurrence soon after surgery. The causes may be:
- If you’ve had the same valve replaced numerous times, weak tissues occur
- If you have been treated for endocarditis, infection can weaken the sutures
- If there is severe calcification of the valve annulus, the stitches pull through the chalk
Treatments include redo surgery or device-based Paravalvular Leak Closure.
Your Cardiologist will perform an Echocardiogram to confirm a Paravalvular Leak and will help to choose the right strategy to treat your condition. In addition, blood tests, a Transoesophageal Echocardiogram (TOE) and CT scanning are usually needed.
How is a Paravalvular Leak Closure performed?
A paravalvular leak closure is a similar procedure to that of an angiogram or angioplasty.
Before your procedure you will be given a general anaesthetic. To help your consultant navigate, your operation will be guided by X-rays and ultrasound pictures from a probe in your throat (TOE).
Your Cardiologist will steer a wire across the leak, and then an umbrella-like device will be passed through a catheter which will be placed from your groin up to your heart and across the gap between the valve and the heart tissue.
The device is deployed after testing the stability and function of the valves.
Two plugs to plug two leaks
Two leaks beside the aortic valve
Risks with a Paravalvular Leak Closure
Device based Paravalvular Leak Closure is safe, and is seen as lower risk than redo open heart surgery. As with any procedure there can be risks, and with Paravalvular Leak Closure these include:
- At the groin site- bruising, bleeding infection
- Stroke or heart attack
- Increased valve dysfunction – if the umbrella device upsets the artificial heart valve
- Anaemia- if a small hole is left behind, blood can be damaged as it passes through – haemolysis
- Device embolization – if the device moves after deployment