Paravalvular Leak (PVL) Closure

When you’ve had a heart valve replaced, infection or mineral deposits can eventually cause the new, artificial valve to leak.
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If you have moderate to severe leakage—known as a paravalvular leak, or PVL—your doctor may recommend a procedure to repair the leak.

Most repairs can be done with a minimally invasive procedure. The UI Heart and Vascular Center heart valve team specializes in evaluating PVLs and creating a treatment plan tailored to your unique needs.

With fellowship training and special expertise in PVL repair, our team has experience repairing the most complex heart valve problems successfully. As the only center in Iowa offering a comprehensive minimally invasive valve repair program, we see patients from all over the state and western Illinois.

Our minimally invasive approach to PVL closure

Traditionally, fixing a PVL requires open heart surgery. That’s still an option if the leak is especially large or a previous minimally invasive procedure has failed. But in most cases, our highly experienced specialists can repair the leak with a nonsurgical procedure.

Our team of interventional cardiologists, heart surgeons, and imaging experts starts by thoroughly assessing your PVL. They’ll use imaging, including an echocardiogram and CT scans, to study the size and location of the leak and make a plan.

If nonsurgical repair is right for you, here’s the typical process:

  • Your cardiologist will insert a thin, flexible tube called a catheter into a blood vessel in your groin.
  • Your cardiologist will advance the catheter through the blood vessels to the site of the leaking valve.
  • Guided by X-ray and cardiac ultrasound equipment, the doctor uses the catheter to place one or more specialized closure devices to plug the leak.
  • Most people stay in the hospital for one night. You’ll be up and walking the next day and can get back to normal activities in one to two weeks.

Our team is the only one in Iowa that regularly performs these catheter based PVL procedures. Our experience means that we have a high success rate and a low rate of complications.

Are you a candidate for PVL closure?

A leaky valve causes regurgitation, or blood backing up into the heart. This can result in problems such as congestive heart failure and an increased risk of future infections. It can also cause hemolysis, a condition where blood cells are damaged, potentially causing you to become anemic.

Symptoms of a PVL can include the following:

  • Fatigue
  • Shortness of breath
  • Heart murmur
  • Rapid or fluttering heartbeats
  • Swelling in your ankles or feet

If you have any of these symptoms, you should see your doctor as soon as possible to avoid heart damage.

Our Care Team

Phillip Horwitz, MD portrait

Phillip
Horwitz
MD

  • Heart and Vascular
4.80 out of 5 (756 ratings)
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James
Rossen
MD

  • Heart and Vascular
4.60 out of 5 (579 ratings)

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Locations and Offices

Heart and Vascular Center
4800 John Pappajohn Pavilion (JPP)
Level 4, Elevator I
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In Medical Center
200 Hawkins Drive, Iowa City, IA 52242
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Awards and Recognition

The nation's first Heart Valve Center of Excellence
UI Health Care was the first system in the U.S. to be certified as a Heart Valve Center of Excellence by the Joint Commission.