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    4. Paravalvular leak closure

    Paravalvular leak closure

    At Mayo Clinic Healthcare, our cardiology specialists provide expert assessment, personalised treatment, and tailored recovery plans for patients with a paravalvular leak (PVL). If you have been advised to undergo paravalvular leak closure or are experiencing symptoms following heart valve surgery, our team provides prompt access to specialist care.

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    • A paravalvular leak (PVL) is an uncommon complication that may occur after heart valve replacement surgery. It occurs when blood leaks around the prosthetic valve rather than flowing through it.

      This backflow, also known as paravalvular regurgitation, occurs when blood passes between the sewing ring (the fabric cuff of the artificial valve) and the surrounding heart tissue.

      Several factors can affect the tissue surrounding a prosthetic valve, including infection (such as endocarditis), calcification, fragile heart tissue, or problems with how the valve attaches to the heart. Over time, these issues may create small gaps between the sewing ring and the valve annulus, allowing blood to leak around the valve.

    • Symptoms associated with a PVL heart valve leak may include:

      • Shortness of breath
      • Fatigue and weakness
      • Swelling in the legs or ankles

      If left untreated, a significant paravalvular leak may lead to worsening heart symptoms or other complications.

    • A transoesophageal echocardiogram (TOE) is typically the primary test used to diagnose a paravalvular leak. This imaging test allows cardiologists to examine the prosthetic valve in detail and identify any leakage around the valve.

      In some cases, a CT scan may also be performed to provide additional detail.

    • During your initial consultation, your cardiology specialist will review your medical history and discuss your symptoms and previous heart valve procedure.

      Your consultant may ask questions about:

      • The symptoms you are experiencing
      • When your valve replacement procedure was performed
      • Any treatments or medications you are currently taking

      This discussion helps your specialist determine whether further investigations or treatment may be required.

    • The most appropriate treatment depends on the size and severity of the leak, as well as your overall health. In many cases, a minimally invasive catheter-based procedure can be used to close the leak. In more complex cases, surgical treatment may be considered.

      Your cardiologist will recommend the most appropriate treatment approach based on your individual condition.

    • The most common treatment for PVL is percutaneous paravalvular leak closure, a minimally invasive procedure typically performed under general anaesthesia.

      During the procedure:

      • A small incision is made in the groin to access a blood vessel
      • A catheter and guidewire are advanced through the blood vessels to the heart
      • A specialised closure device is positioned to seal the leak around the prosthetic valve

      In many cases, this procedure significantly reduces the leak and improves symptoms.

    • Before the procedure, your cardiologist will perform several tests to assess the severity of the leak and plan treatment.

      These may include:

      You will usually be asked to fast for approximately six hours before the procedure and will receive instructions regarding any medications that should be temporarily stopped.

    • Recovery following paravalvular leak closure typically takes several weeks. Most patients remain in hospital for one night before being discharged to continue recovery at home.

      Your cardiology specialist may recommend:

      • Medication such as blood thinners to reduce the risk of blood clots
      • Avoiding strenuous activity for a short period during recovery

      Your care team will provide detailed guidance and personalised recommendations based on your condition and treatment.

    Private health insurance for paravalvular leak closure treatment

    Mayo Clinic Healthcare works with major private health insurance providers, including AXA PPP, Aviva, BUPA, Vitality Health and WPA. Self-pay arrangements are also available.

    Our London clinic team can assist with appointment scheduling, insurance queries and treatment planning.

    If you would like to arrange a consultation with a cardiology specialist, you can request an appointment with our team or call us on +44 (0)2078712575.

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