The management of paravalvular leaks post aortic valve replacement

BACKGROUND: Paravalvular leak (PVL) is uncommon but can lead to severe complications after surgical or transcatheter aortic valve implantation. Conditions associated with PVLs such as heart failure, hemolysis, and infective endocarditis can lead to catastrophic results if not treated promptly; the therapeutic goals differ according to the presentation. It is vital that PVLs are diagnosed early using various imaging modalities. Different approaches have been studied in managing PVLs; there is an increased interest in the transcatheter aortic valve closure procedure as it is minimally invasive and decreases the occurrence of further reinterventions. AIM: To discuss the classification of PVLs, diagnostic approaches, and available management options. METHOD: A literature review was performed using 28 studies. RESULTS: This review evaluated the relationship between the time of diagnosis, management of PVL and the resulting outcomes. DISCUSSION: Patients with PVL should be assessed through a multidisciplinary team approach and a patient-selective plan should be in place. CONCLUSION: Open surgical intervention is reserved for complex cases where minimally invasive techniques cannot be utilized.