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J Thorac Cardiovasc Surg 2004;128:771-772
© 2004 The American Association for Thoracic Surgery

Brief communication

A technique for repair of mitral paravalvular leak

^a Cardiac Surgical Unit and Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass, USA

Received for publication March 18, 2004; revisions received April 14, 2004; accepted for publication April 26, 2004.

^* Address for reprints: David F. Torchiana, MD, Bullfinch 208, Massachusetts General Hospital, Boston, MA 02114, USA
dtorchiana@partners.org

The first 20% of the full text of this article appears below.

The incidence of paravalvular leak 15 years after mitral valve replacement (MVR) approximates 17%.^1,2 Its relative incidence after mechanical and bioprosthetic replacement is debated.¹ Running monofilament suture techniques³ and MVR for endocarditis⁴ have been implicated in the development of paravalvular leaks. Twenty-two percent of patients with paravalvular leaks are diagnosed in the first week after MVR, and another 52% are diagnosed within the first postoperative year. Patients requiring operative repair are older, have symptomatic heart failure, hemolytic anemia, and larger leaks. Surgical intervention to repair the leak improves symptoms of congestive heart failure, augments the hematocrit value, decreases the need for blood transfusion, and is an independent predictor of long-term survival when compared with medical therapy.⁴ Choice of operation involves either direct suture repair of the leak site, which carries a failure rate of 13%; or replacement of the valve, which carries a failure rate of up to 35% and poses a technical challenge. Here we propose . . . [Full Text of this Article]

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				I. E. Konstantinov A new technique for repair of mitral paravalvular leak? J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 614 - 615. [Full Text] [PDF]