Mitral Paravalvular Leak Closure: Transcatheter and Surgical Solutions

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.