Paravalvular Leakage after Mitral Valve Replacement:
Is Left Atrial Enlargement an Additional Indication for Reoperation?
Kaan Kirali MD, Denyan Mansuroglu MD, Bengi Yaymaci MD, Suat Nail Ömeroglu MD, Yelda Basaran MD, Gökhan Ipek MD, Cevat Yakut MD

Paravalvular leakage is a rare complication after mitral valve replacement (MVR), and may impair cardiac function and reduce the patientŐs functional capacity. Among 2,502 patients who underwent MVR, 33 (1.32%) had paravalvular leakage of differing degree. Annular calcification (33.0%) and infective endocarditis (18.2%) were important risk factors for paravalvular leakage. Fourteen of the 33 patients (42.4%) were reoperated on. Reoperative mortality was 3.0%, and late mortality 3.1%. There was no preoperative predictor for the development of severe paravalvular leakage requiring reoperation. If paravalvular leakage reduces a patientŐs functional capacity, or if severe paravalvular leakage is evaluated echocardiographically, then reoperation must be performed.