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.


Charles Estes - Aortic Valve Stenosis
Charles Estes – Aortic Valve Stenosis
89 year old Charles Estes was not about to let a heart valve problem slow him down. The WWII vet volunteered to be the first person in Alabama to undergo a new minimally invasive procedure for aortic valve replacement.
Wade Gladden - Aortic Valve Stenosis
Wade Gladden – Aortic Valve Stenosis
At 90-plus years old, Mr. Gladden’s heart was weakened, he had aortic valve disease and needed multiple procedures. With help from UAB’s team of cardiovascular sub-specialists, the veteran has survived and thrived.
Gil Barrow - 500th TAVR Patient
Gil Barrow – 500th TAVR Patient
Pastor, professional baseball player, heart attack survivor. Gil Barrow has experienced many things in his life, but he never thought the latter would be a part of his story. Now, because of his new opportunities in both health and retirement, he has spread the word about TAVR and the doctors at UAB who helped him get back on the right track.
Sarah Ford | Heart surgery at UAB
Sarah’s Heart
When Sarah Ford found out she needed heart surgery, she made the drive from her home in Dothan to Birmingham to receive treatment at UAB. The experienced surgeons, compassionate staff, and cutting-edge care at UAB made her feel secure and safe.

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