Why Choose Penn Medicine 

After a heart valve replacement, you may develop a paravalvular leak in the space between your heart tissue and new valve. Paravalvular leaks (also called paravalvular regurgitation) occur in up to 25 percent of patients following transcatheter aortic valve replacement (TAVR) and up to 5 percent of patients after surgical valve replacement.

Paravalvular leak closure can often be treated with medication alone. When medications are not enough, Penn cardiologists correct paravalvular leaks with a nonsurgical, catheter-based procedure — saving patients a repeat heart surgery. Our interventional cardiologists repair even the most complex paravalvular leaks when other health systems can

Paravalvular Leak Closure Overview 

Paravalvular leak closure is a collaborative effort by a team of interventional cardiologists and imaging specialists. Together they diagnose the leak with advanced imaging procedures and use a catheter (long, thin tube) and a small plug to repair the leak.

Diagnosing Paravalvular Regurgitation

A paravalvular leak may initially present as a heart murmur or severe anemia (diagnosed through a blood test). If you have a larger leak, you may have symptoms of heart failure, which include:

  • Shortness of breath
  • Unexpected and rapid weight gain
  • Swelling in feet and legs

Your cardiologist may order tests to rule out infective endocarditis, an infection of your heart’s lining. We use specialized cardiovascular imaging techniques, such as echocardiography (echo) and transesophageal echocardiogram (TEE), to diagnose a paravalvular leak and determine the treatment plan.

Paravalvular Leak Closure: What to Expect

Our interventional cardiologists perform paravalvular leak closures in a catheterization lab. You will be administered a general anesthetic to keep you comfortable. During the procedure, your cardiologist will:

  • Insert a catheter into the femoral artery or vein in your groin.
  • Use advanced imaging techniques to guide the catheter to your heart.
  • Place a closure device (plug) on the leak.
  • Remove the catheter from your blood vessel.

Our cardiac team monitors your recovery closely. Three months after the procedure, your cardiologist may conduct another TEE to assess the position of the closure device and any residual leaking. Eventually, your heart tissue will grow around the plug and it becomes part of your heart.

Benefits of a Catheter-Based Paravalvular Leak Closure

Paravalvular leaks were traditionally treated with additional heart surgery. As a nonsurgical procedure, catheter-based paravalvular leak closure offers many benefits, including:

  • Immediate relief from symptoms associated with paravalvular leak
  • Less invasive procedure with no incisions
  • Low rates of complication
  • Quick recovery and short hospital stay

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