Mustafa Ozan Gürsoy1,5, Macit Kalçık1, Mehmet Özkan1,2, Mehmet Ali Astarcıoğlu1, Süleyman Karakoyun1,3, Sabahattin Gündüz1, Tayyar Gökdeniz1,3, Mahmut Yesin1, Mehmet Altuğ Tuncer4, Cengiz Köksal41Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
2School of Health Sciences, Ardahan University, Ardahan, Turkey
3Department of Cardiology, Kars Kafkas University, Faculty of Medicine, Kars, Turkey
4Department of Cardiovascular Surgery, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
5Electronic correspondence: firstname.lastname@example.org
Background and aim of the study: Paravalvular leakage (PVL) remains an unavoidable complication of heart valve surgery and in its severe forms may lead to heart failure and hemolysis. The study aim was to evaluate the echocardiographic, clinical, surgical and laboratory characteristics of patients with aortic PVL.
Methods: A total of 77 aortic PVL patients underwent transthoracic and transesophageal echocardiography examinations. Clinical, echocardiographical and surgical findings were also recorded.
Results: Among the 77 patients, 21 (27.3%) had mild, 33 (42.8%) had moderate and 23 (29.9%) had severe aortic PVL. Seventeen patients (22.1%) had moderate-to-severe hemolysis and had a higher incidence of multiple PVL compared to those with no or mild hemolysis. Moderate-
to-severe PVL was more frequent between the non-coronary and the left coronary sinus annuli, especially adjacent to the left main coronary artery ostium. Percutaneous closure was performed in five patients. Eleven patients underwent surgical repair, and the localizations of PVL were in accordance with echocardiographic findings.
Conclusion: Aortic PVL occurs more frequently between the non-coronary sinus and the left coronary sinus annuli, which may be associated with multiple factors. Difficulties in seating the prosthesis due to the steep angulation of the commissure and annulus, the avoidance of deep sutures, and focal annular calcification may make this region prone to injury and leakage.
The Journal of Heart Valve Disease 2016;25:403-409
|Evaluation of Aortic Paravalvular Leak: A Special Reference for Anatomical Localization|
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