Aortic Periprosthetic Leak

Aortic periprosthetic leak, or aortic periprosthetic valve leak, is a condition that sometimes occurs following surgery to replace the heart’s aortic valve with a mechanical valve. Periprosthetic essentially means “around the prosthetic,” which in this case refers to the mechanical valve. Periprosthetic leakage (PPL) is one of the most common reasons a second surgery is required following valve replacement.

To understand why valve replacement is needed, it’s important to know the function of the aortic valve. Normally, blood is pumped from the left chamber of the heart, called the ventricle, to the aorta, a large blood vessel that transports oxygen-rich blood throughout the body. The heart’s aortic valve controls the flow of blood between the ventricle and the aorta by closing between beats (when the heart is at rest) to help prevent a backflow of blood into the heart. If the aortic valve malfunctions or fails to close properly, blood regurgitates or leaks back into the heart’s ventricle, resulting in aortic valve regurgitation. This prevents the body from getting the proper amount of blood and requires the heart to work harder to pump the blood. Aortic valve regurgitation may then require surgery to replace the aortic valve with a mechanical or prosthetic valve.

The UAB Structural Heart & Valve Program is the oldest and largest program of its kind in Alabama. It provides ongoing care – sometimes for life – to patients who have or are at risk for structural heart and valve disease. Our experienced surgeons and cardiologists take a comprehensive approach to diagnosing and treating this condition, and their expertise ranges from traditional open-heart surgery to robotic-assisted valve repair and the latest in minimally invasive surgical techniques, which require only small incisions (cuts).

The UAB Structural Heart & Valve Clinic has achieved several important milestones in the past decade. In 2012, we performed the first transcatheter aortic valve replacement (TAVR) in Alabama, and UAB has performed more TAVR procedures than any other hospital in the state. As an added service, patients who have been told by non-UAB doctors that they need valve surgery can speak to a UAB structural heart and valve surgeon for a second opinion.

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