Department of Cardiology, Memorial Ankara Hospital, Ankara, Turkey.
Division of Cardiac Surgery, Medical University Graz, Austria; Heart Team Austria and Karl Landsteiner Institute for Cardiovascular Research, Austria.
Cardiovasc Revasc Med. 2020 Mar;21(3):422-431. doi: 10.1016/j.carrev.2019.06.012. Epub 2019 Jun 28.
Paravalvular leak (PVL) is an important complication after surgical valve replacement and might lead to serious clinical results, including heart failure and/or hemolytic anemia. PVLs are the result of an incomplete seal between the sewing ring and annulus. It frequently affects surgical valves in the mitral position, occurring in 5% to 15% of valve replacements. For years, surgery has been considered the only treatment for symptomatic patients with PVLs. However, surgical re-intervention for PVLs is associated with a high risk of morbidity and mortality. Therefore, percutaneous treatment of PVL has become first-line therapy for most patients with symptomatic PVL. In this review, we will briefly summarize clinical findings, diagnostic modalities, laboratory assessment, surgical treatment, transcatheter approaches, device choice and outcomes of interventions in mitral PVLs.
瓣周漏(PVL)是心脏瓣膜置换术后的一个重要并发症,可能导致严重的临床后果,包括心力衰竭和/或溶血性贫血。PVL 是由于缝合环和瓣环之间不完全密封所致。它常影响二尖瓣位置的外科瓣膜,在 5%至 15%的瓣膜置换中发生。多年来,手术一直被认为是治疗有症状的 PVL 患者的唯一方法。然而,PVL 患者再次手术的风险较高,死亡率也较高。因此,经皮治疗 PVL 已成为大多数有症状的 PVL 患者的一线治疗方法。在这篇综述中,我们将简要总结二尖瓣 PVL 的临床发现、诊断方法、实验室评估、手术治疗、经导管方法、器械选择和干预结果。