Para-valvular Leak Closure

Overview

With the advances in  techniques to treat structural heart disease comes a procedure for plugging holes which may appear over time at the edge of prosthetic heart valves.

Using special devices delivered through catheters and guided using x-rays and ultrasound these para-prosthetic leaks can be reduced thereby avoiding the need for redo open heart valve replacement surgery.

Do I need paravalvular leak closure?

Paravalvular leak is a rare complication in the surgical treatment of valve disease. Leaks can emerge slowly over time or can be an acute occurrence, for example after infection on the valve. Once there is enough leakage heart failure, endocarditis, or haemolysis (anaemia) can follow. The presence of paravalvular leak is commonly confirmed by echocardiography and your cardiologist will help you in choosing which strategy to use in treating your condition.

A “plug” to block up the leak at the side of an artificial valve.

What is involved and what are the risks?

Paravalvular leak closure is done using a technique similar to an angiogram or angioplasty. You are usually given a general anaesthetic, as we would want to use transoesophageal echocardiography to help direct the procedure, in addition to X-rays. A pipe is taken from the leg artery or vein  up to the heart. The device, commonly a umbrella shaped piece of equipment, is passed through the tube and across the gap between the valve and the heart tissue. The device is deployed after testing stability and the function of the valves. The tubes are removed and the wound is pressed on.

This can be a complicated and sometimes lengthy procedure and there are risks that are higher than angioplasty, but certainly lower than conventional redo valve surgery.

Click here to see the first of a three part video of a live para-valvular leak closure.

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