ISSN 2149-2263 | E-ISSN 2149-2271
A comprehensive review of the diagnosis and management of mitral paravalvular leakage [Anatol J Cardiol]
Anatol J Cardiol. 2020; 24(6): 350-360 | DOI: 10.14744/AnatolJCardiol.2020.10018

A comprehensive review of the diagnosis and management of mitral paravalvular leakage

Mustafa Ozan Gürsoy1, Ahmet Güner2, Macit Kalçık3, Emrah Bayam4, Mehmet Özkan4
1Department of Cardiology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital; İzmir-Turkey
2Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
3Department of Cardiology, Faculty of Medicine, Hitit University; Çorum-Turkey
4Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital; İstanbul-Turkey

Mitral paravalvular leaks (PVLs) commonly occur in patients with prosthetic valves. Paravalvular defects may be clinically inconsequential and may aggravate hemolysis or cause heart failure through regurgitation. Accordingly, patients may eventually require intervention such as redo surgery or a transcatheter closure of the defects. The introduction of purpose-specific closure devices and new steerable catheters has opened a new frontier for the transcatheter PVL closure. This mode of treatment is an initial therapy in most centers with experienced structural heart team. However, head-to-head data comparing two treatment modalities (surgery and transcatheter closure) are limited, and the world-wide experience is based on nonrandomized studies. Multimodality imaging, including three-dimensional transesophageal echocardiography, facilitates the delineation of mitral PVLs and provides essential data that aids the communication between the members of the structural heart team. In the near future, the success of interventional therapies will most probably increase in patients with mitral PVLs with the introduction of hybrid imaging modalities (echocardiography, cardiac computed tomography, and fluoroscopy). In conclusion, this paper summarizes the etiopathogenesis, clinical characteristics, diagnosis, and treatment of mitral PVLs.

Keywords: mitral valve, echocardiography, transcatheter closure, cardiac surgery

Mustafa Ozan Gürsoy, Ahmet Güner, Macit Kalçık, Emrah Bayam, Mehmet Özkan. A comprehensive review of the diagnosis and management of mitral paravalvular leakage. Anatol J Cardiol. 2020; 24(6): 350-360

Corresponding Author: Ahmet Güner, Türkiye
Manuscript Language: English

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