Paravalvular leaks: mechanisms, diagnosis and management.

摘要: Aims To understand the incidence, aetiology and mechanisms of paravalvular aortic mitral leaks after valvular surgery; reviewing best methods for diagnosis, procedural guidance result assessment these leaks, as well describing different approaches to their treatment. Methods results A literature search was undertaken an in-depth analysis our own experience concerning imaging modalities various therapeutic strategies leaks. The majority patients were diagnosed using two- or three-dimensional transoesophageal echocardiography, useful in both guiding procedure assessing results. Haemoglobin, haematocrit, LDH haptoglobin values analysed assess haemolysis. Procedural success percutaneous closure are around 90% series, with low complication rates. Mitral have been approached by transfemoral transapical access; reported this ranges from 75% more than reports. Complication rates at 30 days average 10% mortality related is 1%. Late follow-up depend on initial anatomy, baseline clinical class Conclusions Paravalvular surgical valve implantation a multifactorial aetiology, but mainly specific anatomic characteristics ring. three times common incidence increases reoperation. Different techniques several devices explored leak closure, we still lacking specifically designed treat pathology effectively.