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Paravalvular leak (PVL) is uncommon but can lead to severe complications after surgical or transcatheter aortic valve replacement. Clinical complications such as heart failure, haemolysis and infective endocarditis can be catastrophic results if not treated in promptly. It is, therefore, vital that PVLs are diagnosed early using various imaging modalities. Different approaches have been studies in managing PVL’s; of late, there is an increased interest in the use of minimally invasive procedures such as the transcatheter aortic valve closure procedure due to the decreased occurrence of further operations. This review discusses the classification of PVLs, diagnostic approaches and the available management options.

Background: Paravalvular leak (PVL) is uncommon but can lead to severe complications after surgical or transcatheter aortic valve implantation. Conditions associated with PVLs such as heart failure, hemolysis, and infective endocarditis can lead to catastrophic results if not treated promptly; the therapeutic goals differ according to the presentation. It is vital that PVLs are diagnosed early using various imaging modalities. Different approaches have been studied in managing PVLs; there is an increased interest in the transcatheter aortic valve closure procedure as it is minimally invasive and decreases the occurrence of further reinterventions.Aim: To discuss the classification of PVLs, diagnostic approaches, and available management options.Method: A literature review was performed using 28 studies.Results: This review evaluated the relationship between the time of diagnosis, management of PVL and the resulting outcomes.Discussion: Patients with PVL should be assessed through a multidisciplinary team approach and a patient-selective plan should be in place. Conclusion:Open surgical intervention is reserved for complex cases where minimally invasive techniques cannot be utilized.

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In this study 50 chronic renal failure patients were tested for blood ABO groups and for the presence of lymphocytotoxic antibodies against a panel of 20 donor lymphocytes (of known HLA types) using microcytotoxicity assay. The influence of other factors affecting sensitization, such as number of blood transfusions, pregnancies and previous graft rejections were analyzed too. The results showed that41.2 % of blood group 0 patients, 61.1 % of group A I, 90% of group B, and 80% of group A IB are sensitized (PRA> 10%). These results pointed to higher incidence of sensitization in patients with blood groups Band A IB as compared to groups A I and 0. Our data suggest an impact of the ABO system on the sensitization phenomenon.