[Clinical analysis in 34 cases of paravalvular leakage after valve replacement].
OBJECTIVE
To study the treatment of paravalvular leakage (PVL) after cardiac valve replacement retrospectively.


METHODS
Between 1993 and 2005, 34 patients with PVL were observed, including aortic PVL in 6 patients and mitral valve PVL in 28 patients. Twenty-five patients with severe anemia and/or heart failure were reoperated, 9 patients without severe clinical symptoms and signs had treated conservatively. Repair of PVL was carried out in 14 patients, and the other 10 patients were performed prosthetic valve replacement.


RESULTS
Of 9 patients who had treated conservatively, 1 patients died of septic shock, and 1 patient died of heart failure. During 6 - 72 months follow-up, of the seven survivals, 2 patients died of heart failure. And the other 5 patients were in NYHA class II. Echocardiography demonstrated no obvious enlargement of the PVL and diameter of the heart. Among the 25 patients who were reoperated, the overall operative mortality was 12% (3 patients). Twenty-one survivals were in NYHA class II during the follow-up of 4 - 132 months. While a mitral valve PVL and a aortic valve PVL were diagnosed among them after the reoperation 4 years and 6 months respectively.


CONCLUSIONS
Patients with PVL and no severe symptoms can be treated conservatively and followed up. A more aggressive surgical treatment is recommended for patients with PVL and severe anemia and/or heart failure.
Wang
Jian-gang
JG
Department of Cardiac Surgery, Anzhen Hospital, Capital University of Medicine, Beijing 100029, China. wangjiangang7545@126.com
Meng
Xu
X
Zheng
Si-hong
SH
Hou
Xiao-tong
XT
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome