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Early paravalvular leak after conventional mitral valve replacement: A single-center analysis

Matteo Matteucci1, Sandro Ferrarese1, Cristiano Cantore1

  • 1Department of Medicine and Surgery, Cardiac Surgery Unit, Circolo Hospital, University of Insubria, Varese, Italy.

Journal of Cardiac Surgery
|March 15, 2022
PubMed
Abstract

Insights

Early mitral paravalvular leak (PVL) after mitral valve replacement (MVR) is uncommon and typically mild. Infective endocarditis significantly increases the risk of PVL development.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Prosthetic Valve Complications

Background:

  • Paravalvular leak (PVL) is a known complication following mitral valve replacement (MVR).
  • Limited studies analyze PVL occurrence and outcomes after surgical MVR.
  • Understanding PVL determinants is crucial for improving patient results.

Purpose of the Study:

  • To determine the incidence and predictors of early mitral PVL after MVR.
  • To evaluate the impact of early PVL on patient survival.

Main Methods:

  • Retrospective analysis of 494 patients undergoing MVR (2012-2019).
  • Postoperative transthoracic echocardiography for PVL assessment.
  • Multivariable logistic regression to identify PVL predictors.

Main Results:

  • Early mitral PVL occurred in 3.2% of patients, mostly mild.
  • Posterior annular segments were the most frequent leak location (62.5%).
  • Infective endocarditis was the sole predictor of early PVL (OR: 4.96, p=0.011).
  • Overall 4.7-year mortality was 19.6%, lower in patients without PVL.

Conclusions:

  • The incidence of early PVL post-MVR is low.
  • PVL is generally mild and often located posteriorly.
  • Preoperative infective endocarditis is a significant risk factor for PVL.
Keywords:
mitral regurgitationmitral valve replacementparavalvular leak

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