Paravalvular regurgitation is an uncommon but important complication, usually following valve replacement surgery. Early recognition and management are important for reop erations are associated with high morbidity and mortality rates. Presently, little data are available on this topic. The authors review the subject.
Fernandez J. , Kaub GW, Adkins MS, et al: Early and late-phase events after valve replacement with St. Jude Medical prosthesis in 1,200 patients . J Thorac Cardiovasc Surg107:394-407, 1994.
Hannermeister KE, Sethi GK, Henderson WG, et al: A comparison of outcome in men 11 years after heart valve replacement with a mechanical or bioprosthesis. N Engl J Med328:1289-1296, 1993.
5.
Nakano K., Koyanagi H., Hashimoto A., et al: Twelve years' experience with St. Jude Medical valve prosthesis . Ann Thorac Surg57:697-703, 1994.
6.
Arom KV, Nicoloff DM, Kersten TE, et al: Ten years' experience with St. Jude Medical valve prosthesis . Ann Thorac Surg47:831-837, 1989.
7.
Rutledge R., Kim J., Appelbaum R.: Actuarial analysis of prosthetic valve endocarditis in 1,598 patients with mechanical and bioprosthetic valvesArch Surg120:469-472, 1985.
Arvay A., Lengyel M.: Incidence and risk factors of prosthetic valve endocarditis. Eur J Cardiothorac Surg2:340-346, 1988.
10.
Bjork VO: Surgical treatment of recurrent aortic insufficiency after aortic valve replacement with Starr-Edwards ball valve prosthesis. Thorax21:450, 1966.
11.
Favalaro RG , Effler DB, Groves LK: Surgical repair of leaking prosthetic heart valves. Ann Thorac Surg3:503-513, 1967.
12.
Joassin A., Edwards JE: Causes of death within 30 days of mitral valve replacement. Analysis of 93 patientsCardiovasc Clin5:169-184, 1973.
13.
Sandaza JG Jr, Clark RE, Ferguson TB, et al: Replacement of prosthetic heart valves. J Thorac Cardiovasc Surg74:864-874, 1977.
14.
Rosenthal DS , Handin RI, et al: Hematologic-oncologic disorders and heart disease In: Heart Diseases: A Text Book of Cardiovascular Medicine, ed 2, ed. by Braunwald E.Philadelphia: WB Saunders Co, 1984 , p 1680.
15.
Sezia Y., Umeda S., Okazaki T., et al: Hemodynamic and hemolytic features of the St. Jude Medical valve prosthesis. J Cardiovasc Surg25:16-24, 1984.
16.
Rubinson RM , Morrow AG, Gebel P.: Mechanical destruction of erythrocytes by incompetent aortic valvular prosthesis. Am Heart J71:179-186, 1966.
17.
Hockett RD Jr, Krewson L., Weiss A., et al: Severe paravalvular mechanical hemolysis with a normal blood smear. Am J Clin Pathol92:513-515, 1989.
18.
Roberts WC, Morrow AG: Secondary left ventricular endocardial fibroelastosis following mitral valve replacement. Cause of failure in the late postoperative periodCirculation37,38 (suppl II):II-101, 1968.
Reddy ER, Addetia A., Stone EW: Paravalvular aortic rupture causing angina following aortic valve replacement . Cardiovasc Intervent Radiol18:321-322, 1995.
Effron MK, Popp RL: Two-dimensional echocardiographic assessment of bioprosthetic valve dysfunction and infective endocarditis. J Am Coll Cardiol2:597-606, 1983.
23.
Chen YT, Kan MN, Chen JS, et al: Detection of prosthetic mitral valve leak: A comparative study using transesophageal echocardiography, transthoracic echocardiography, and auscultation. J Clin Ultrasound18:557-561, 1990.
24.
Flachskampf FA, Hoffman R., Franke A., et al: Does multiplane transesophageal echocardiography improve the assessment of paravalvular regurgitation ? J Am Soc Echocardiogr8:70-78, 1995.
25.
Connolly HM , Miller FA Jr, Taylor CL, et al: Doppler hemodynamic profile of 86 normal tricuspid valve prosthesis [Abstract]. J Am Coll Cardiol67 :869-872, 1991.
26.
Alam M., Rosman HS, Hautamaki K., et al: Color flow Doppler evaluation of bioprosthesis valves. Am J Cardiol64:1389-1392, 1989 .
27.
Nellessen U. , Schnittger I., Appelton CP, et al: Transesophageal 2-D echocardiography and color Doppler flow velocity mapping in the evaluation of cardiac valve prosthesis. Circulation78:848-855, 1988.
28.
Omran H., Fehske W., Hagendorff A., et al: Paraprosthetic regurgitation in aortic prostheses: Determination of the hemodynamic significance by pulsed Doppler examination of the subclavian artery flow. J Heart Valve Dis4:166-170, 1995.
29.
Akasaka T., Yoshikawa J., Yoshida K., et al: Late complications of valve replacement: The benefits of noninvasive assessment. J Cardiol18:163-178, 1988.
30.
Panidis IP, Ross J., Mintz GS: Normal and abnormal prosthetic valve function as assessed by Doppler echocardiography . J Am Coll Cardiol8:317-326, 1986.
31.
Cheitlin MD, Alpert JS, Armstrong WF, et al: ACC/AHA guidelines for clinical application of echocardiography: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography)Circulation95:1686-1744, 1997 .
32.
Smith RE, Berg D.: Occult paravalvular leak in a clinically normal St. Jude's mitral valve presenting with life-threatening microangiopathic hemolytic anemia. J Cardiovasc Surg32:56-58, 1991.
33.
Duvernoy WF , Gonzalez-Lavin L., Anbe DT: Spontaneous closure of paravalvular leak after mitral valve replacement. Chest68:102-104, 1975.
34.
Movoswitz HD , Shah SI, Ioloi A., et al: Long-term follow-up of mitral paraprosthetic regurgitation by transesophageal echocardiography. J Am Soc Echocardiogr7:488-492, 1994.
35.
Echevarria JR, Bernal JM, Rabasa JM, et al: Reoperation for bioprosthetic valve dysfunction. A decade of clinical experience. Eur J Cardiothorac Surg5:523-526, 1991.
36.
Bendet IaA , Ishchenko OA, Panichkin IuV , et al: Paravalvular insufficiency following heart valve prosthesis [Russian]. Grudnaia I Serdschno-Sosudistaia Khirurgiia2:6-8, 1991.
37.
Stewart S., Deweese JA: The determinants of survival following reoperation on prosthetic cardiac valves . Ann Thorac Surg25:555-557, 1978.
38.
Hourihan M. , Perry SB, Mendell VS, et al: Transcatheter closure of valvular and paravalvular leaks. J Am Coll Cardiol20:1371-1377, 1992.
