Comprehensive Guide to Paravalvular Leak: Symptoms, Effects, and Treatments.

Abstract

Paravalvular leak (PVL) represents a common complication often encountered following valve replacement surgeries, posing significant diagnostic and therapeutic challenges within the field of cardiology. The condition, characterized by an abnormal flow of blood around the edges of a prosthetic valve, can lead to a spectrum of clinical manifestations, from asymptomatic states to severe heart failure or hemolysis. Its relevance is underscored by its contribution to morbidity and mortality among affected individuals, necessitating a deeper understanding of its etiology, diagnosis, and management. The exploration of advanced diagnostic tools, such as echocardiography, computed tomography, and magnetic resonance, alongside novel treatment approaches, underscores the dynamic and evolving landscape of PVL management. This is a concentrated guide to understand the various aspects related to PVL, starting with defining the condition to determine its short- and long-term effects on the patient. It will further direct the reader through diagnosis, going through the advancements made in cardiac imaging, especially three-dimensional modeling and echocardiography. The discussion of predisposing factors, technical considerations intrinsic to procedural interventions, and clinical implications is therefore an important part of the discourse and helps set a foundation for an in-depth exploration of contemporary and emerging treatment modalities. From the incorporation of various surgical and percutaneous techniques to the tactical uses of devices, in particular, the AMPLATZer Vascular Plug, associated with the technical development of transcatheter closure, the current review tries to present a panoramic view of PVL management, from diagnosis to closure and insight into mitigation of its impact on outcomes.