Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

Objective: the aim of this study is to report the incidence, causes, severity, and short term outcome of early paravalvular leak in patients with prosthetic cardiac valves Results: early paravalvular leak occurred in 3.75%, 9%, and 35% of patients who underwent mitral valve, aortic valve, and combined mitral and aortic valve replacement respectively. Infective endocarditis, renal impairment, prior mitral and/or aortic valve replacement were important correlates where they were found in 16(64%), 3(12%), 17(68%) and 22(88%) patients with early paravalvular leak with P = <0.001, 0.027, < 0.001, < 0.001 respectively. Paravalvular leak on mitral prosthesis was mild, moderate, and severe in 6 (67%), 1 (11%), and 2 (22%) patients respectively. Paravalvular leak on aortic prosthesis was mild, moderate, and severe in 8 (42%), 4 (16%), and 8 (42%) patients respectively. Early postoperative mortality occurred in 4 (16%) of patients with paravalvular leak after redo surgery due to sepsis. Conclusion: Paravalvular leak is still an important complication of both mitral and aortic valve replacement. Prior valve(s) replacement, preoperative diagnosis of infective endocarditis, and presence of renal impairment were important correlates for paravalvular leak. Surgery should be done in patients with severe PVL as the prognosis is poor without surgery

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