Angina Paravalvular Leak (PVL)
What is a paravalvular leak?
A paravalvular leak (PVL) occurs when gaps develop around a previously replaced heart valve. Blood can leak through these defects, resulting in a paravalvular leak. In general such leaks do not cause great concern; however if the leak becomes significant, then it may lead to the development of a condition called hemolysis, which can lead to the destruction of red blood cells and anemia.
PVLs occur in the main due to simple wear and tear. During heart valve surgery, the replacement valve is stitched in place by the surgeon and, over time, these stitches can work loose. This creates the gaps or defects around the valve, which allow blood to leak through.
What are the symptoms of a paravalvular leak?
With a small leak it is common for no symptoms to show. However, once a leak becomes significant, a shortness of breath, fatigue, heart flutter, heart murmur or atrial fibrillation will be experienced. In a serious leak this may lead to heart failure.
What assessment do I need if I have a paravalvular leak?
Once a paravalvular leak is suspected, your cardiologist will recommend an echocardiogram (TTE). However, PVLs are difficult to detect and therefore a transoesophageal echocardiogram (TOE) may be used to provide a much clearer image of your heart and the location of any leak. In addition, a CT or MRI scan may also be used to determine the location of the leak
What are the treatments for a paravalvular leak?
Your cardiologist may just suggest monitoring the leak. Should it get worse and symptoms develop it can be closed with re-do surgery or through minimal invasive techniques.