BACKGROUND AND AIM OF THE STUDY: Prosthetic @entity339 ( @entity339 ) is associated with @entity2478 in up to 12.5% of @entity1 . The influence of the morphology and location of @entity2478 on clinical symptoms and degree of leak-related @entity2142 is unknown. METHODS: Morphology, size, location and number of @entity2478 were analyzed in 96 consecutive @entity1 with primary mitral @entity2478 . RESULTS: Mitral leak was diagnosed a median of 119 days after primary @entity339 . A small (1-2 mm) @entity2478 was found in 41 @entity1 (43%), an intermediate leak (3-5 mm) in 26 (27%), and a large leak (6-15 mm) in 29 (30%). Single leaks were observed in 70 @entity1 (73%), whilst 26 (27%) had multiple leaks. @entity2478 occurred around the entire prosthetic circumference, but were seen predominantly around the mitral commissural areas (76%). The larger the size of the leak, the more symptomatic the @entity1 (p = 0.006); 80% of @entity1 with small leaks were in NYHA classes I and II, whilst 62% with intermediate/large leaks were in NYHA classes III and IV. The number of leaks was not correlated with severity of clinical symptoms. Multiple leaks were more likely to cause significant @entity2142 . @entity1 with preoperative @entity740 , @entity86 or large (>5 cm) left atria were more likely to develop multiple leaks. The size and location of the leaks was surgeon-dependent. CONCLUSION: Intraoperative transesophageal echocardiography is mandatory to detect possible small leaks and technical errors. Strict monitoring of all @entity339 @entity1 is necessary for prolonged periods, as the appearance of @entity2478 is not necessarily correlated with clinical symptoms. Small @entity2478 , in particular, may go unnoticed. As the location and size of the leaks were significantly surgeon-dependent, self-monitoring should be mandatory for all surgeons.

Does the morphology of mitral XXXX influence symptoms and @entity2142 ?

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity339 :: ('MESH:D008944', 'Disease') :: ['MVR', 'mitral valve replacement'] @entity2478 :: ('MESH:D019559', 'Disease') :: ['Paravalvular leaks', 'paravalvular leaks', 'paravalvular leak'] @entity740 :: ('MESH:D051436', 'Disease') :: ['chronic renal insufficiency'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative infection'] @entity2142 :: ('MESH:D006461', 'Disease') :: ['hemolysis']
@entity2478 :: (MESH:D019559,Disease) :: ['paravalvular leaks']
