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Question:

Can / should a postop leak of a heart valve be repaired?

Greeting,
My name is Dasha and my husband, Phil, had his aortic heart valve surgery in 2007. A year ago at his regular heart follow up, on echocardiogram they discover that his valve is leaking mildly. His heart doctor said not to worry. This year just recently, he went again for his regular appointment and his valve still leaks, a little bit more than last year, but again his heart doctor said not to worry yet. My question is, can that leak be surgery fixed, without having a replacement of a valve? And also, please tell us if he should have his check-ups more than once a year since his valve is leaking like that. Thank you for your time. I will appreciate your answer.

Submitted by Dasha from Florida on 09/22/2014

Unfortunately prosthetic valves sometimes develop small leaks around the sewing ring, even with the best surgical technique, if the tissue being sewn into is not healthy. Usually these stabilize over some weeks and can be “watched” long term. If the leak is mild and relatively stable with no symptoms or serological markers for hemolysis or hemodynamic significance (mild leaks are by definition not clinically significant), it is not unreasonable to follow this annually in the absence of clinical changes. A leak can be fixed surgically & in some cases by newer percutaneous (catheter based) methods, but these are invasive procedures that carry risks that may not be worth taking unless the leak is causing real problems.