Does the morphology of mitral paravalvular leaks influence symptoms and hemolysis?
GROUND AND AIM OF THE STUDY: Prosthetic mitral valve replacement (MVR) is associated with paravalvular leak in up to 12.5% of patients. The influence of the morphology and location of paravalvular leaks on clinical symptoms and degree of leak-related hemolysis is unknown. METHODS: Morphology, size, location and number of paravalvular leaks were analyzed in 96 consecutive patients with primary mitral paravalvular leaks. RESULTS: Mitral leak was diagnosed a median of 119 days after primary MVR. A small (1-2 mm) paravalvular leak was found in 41 patients (43%), an intermediate leak (3-5 mm) in 26 (27%), and a large leak (6-15 mm) in 29 (30%). Single leaks were observed in 70 patients (73%), whilst 26 (27%) had multiple leaks. Paravalvular leaks occurred around the entire prosthetic circumference, but were seen predominantly around the mitral commissural areas (76%). The larger the size of the leak, the more symptomatic the patient (p = 0.006); 80% of patients with small leaks were in NYHA
