Paravalvular leak closure

Introduction

Definition and aetiology

Paravalvular leaks (PVLs) are defined as leakages around a previously implanted prosthesis due to an incomplete apposition of the sewing ring to the native tissue 1. This problem is generally the consequence of suture dehiscence, and it is related to different anatomical and technical factors 2

FOCUS BOX 1Anatomical and technical factors related to paravalvular leaks

Anatomical factors
Annular calcium Friability of the annulus tissue Oval configuration of the native annulus (with circular shape of the prosthesis) Localised infection Lack of space of the valve sutures

Technical factors
Continuous sutures in mitral position Supra-annular implants in aortic position Difficulties in accessing the ring valve tissue Insufficient apposition of the prosthesis (in cases of TAVI)

PVLs after surgical valve replacement (SVR) are frequent, with an estimated incidence of 6% for aortic prostheses and around 32%...