A leaky heart valve, or paravalvular leak, can develop in people who have undergone valve replacement surgery. It occurs when there is space between the replacement valve and normal heart tissue, allowing blood to leak out.
A paravalvular leak is most common in people who have had a mitral valve replacement, though it can also occur in the tricuspid or aortic valves.
Paravalvular Leak Symptoms
If you have undergone valve replacement surgery and then have symptoms of heart failure, your physician will check for a paravalvular leak. Heart failure symptoms include:
- Chest pain
- Difficulty breathing
- Rapid heart beat
- Swelling in the feet and legs
- Unexplained weight gain
If a leak is minor, it may cause hemolytic anemia. Hemolytic anemia means the red blood cells are being destroyed and the body cannot replace them quickly enough.
Symptoms of hemolytic anemia include:
- Enlarged liver and spleen
- Extremely pale skin
- Heart murmur
- Increased heart rate (tachycardia)
- Jaundice (yellowish eyes, mouth and skin)
Paravalvular Leak Diagnosis
Echocardiography (echo) can diagnose paravalvular disease. Echocardiographyis a noninvasive imaging exam that uses sound waves to assess the health of the heart.
Paravalvular Leak Causes and Risk Factors
The most common risk factors for a paravalvular leak are:
- Valve replacement surgery
- Endocarditis, a bacterial infection of the heart
- Having significant calcification, or buildup, on the ring around the valve (valve annulus)
- Undergoing multiple valve replacement surgeries for the same valve
Paravalvular Leak Treatments
Medication can often treat minor leaks, but larger leaks may require a minimally invasive procedure performed by an interventional cardiologist in the cardiac catheterization lab.
During a paravalvular leak closure procedure, an interventional cardiologist will insert a catheter into a vein or artery in the groin area, guide it to the heart and place a closure to plug the leak.