What is a perivalvular leak? A perivalvular leak is a residual leak between the prosthetic ring and the patient’s annulus after valve replacement. Perivalvular leaks are a common complication after valve replacement. The main causes of perivalvular leaks include infective endocarditis, severe annular calcification, and mismatched valve type, with infective endocarditis being the most common. What are the signs of a perivalvular leak? Patients with perivalvular leaks after valve replacement may have postoperative manifestations such as unrelieved chest tightness and shortness of breath, hemolysis, anemia, and hemoglobinuria. Patients with distant or significant effects on cardiac function may have lower extremity edema, significantly decreased activity tolerance, and angina pectoris. Patients with perivalvular leaks have a greater impact on cardiac function and more pronounced manifestations. How is a perivalvular leak diagnosed? It is usually detected by routine transthoracic cardiac ultrasound on postoperative review. If transthoracic ultrasound does not provide a clear diagnosis, transesophageal 3D echocardiography can be performed to clarify the location, size, and shape of the perivalvular leak. How is perivalvular leakage treated? The traditional treatment for perivalvular leaks is re-surgery, with repair of the perivalvular leak or valve replacement under general anesthesia and extracorporeal circulation, but the risks of re-surgery are high and the mortality rate is high. Percutaneous perivalvular leak intervention is a minimally invasive treatment that can be used to seal the perivalvular leak with a specially designed sealer. Minimally invasive interventional treatment of perivalvular leaks is performed through an interventional technique in which a guide wire catheter is delivered via a vascular route to the perivalvular leak to seal it. The patient does not require anesthesia during the procedure and is fully awake. The procedure can be completed by puncturing the patient’s groin only and there is no significant postoperative scarring. The procedure has a high success rate and is significantly less risky than reopening the chest. Cost and length of hospital stay for perivalvular leaks Traditional open surgery for perivalvular leaks is risky and costly (about 100,000+) because it is a second open-heart surgery, and the length of hospital stay is about three weeks. Interventional surgery for perivalvular leaks, on the other hand, does not require an incision, is less risky, generally costs about $40,000, and can be discharged three days after surgery.