Six month echo after TAVR says "mild paravalvular leak". Is my new valve already leaking?

#1Ron Castellano(Joined Feb 2026 · 47 posts)September 29, 2026, 9:25 pm

Some of you will remember my sleepless nights about the valve wearing out. Well, I have found something new to worry about. Had my six month echo last week and the letter has just come. Most of it is good, "well seated valve, gradients satisfactory", whatever that means. Then the line "mild paravalvular regurgitation".

I looked it up and it means a leak AROUND the valve. Six months in! Is that the valve failing already? Is it going to get worse? Will I need another one? The letter just says "for routine review in twelve months" which feels very casual for a leaking heart valve.

#2frankm1952(Joined Apr 2026 · 19 posts)September 30, 2026, 8:45 am

Ron I think mine said "trace" leak at the first check. Nobody seemed bothered. I would not panic over the word mild.

#3TwoNightsTerry(Joined Feb 2026 · 63 posts)September 30, 2026, 1:10 pm

I asked about exactly this last year. My cardiologist drew me a picture, the old valve is lumpy with calcium and the new one is a smooth round tube pressed inside it, so in places there is a tiny gap at the edge. She said a little leak around the edge is common and the question is how much.

#4Dr. Helena VossClinical reviewer(Joined Jan 2026 · 58 posts)October 2, 2026, 11:40 am

Ron Castellano said:

Is that the valve failing already?

Ron, the direct answer is no: a mild paravalvular leak is not the valve failing, and it is one of the more common findings on echocardiograms after TAVR. Terry's picture is a good one. The new valve is expanded inside your own calcified valve, and because that calcium is irregular, the frame does not always seal perfectly at every point around its edge. A small jet of blood can leak back around the outside of the valve, rather than through its leaflets. That is different from the valve itself wearing out, which is what durability worries are about.

What matters is the grade. Paravalvular leaks are described as trace, mild, moderate or severe. Trace and mild leaks are generally not associated with symptoms and are usually monitored rather than treated. Moderate or more is less common with current valve designs and is the degree that is more likely to matter, which is why it is on the list in TAVR risks and complications. A mild leak seen early often stays stable rather than progressing, and a routine follow-up echo is a common plan, so the routine wording in your letter reflects that the team is not concerned, rather than that they are being casual.

The gradients line is good news too. It means blood is flowing through the new valve easily, which is the main thing a TAVR is meant to achieve.

The things that would justify an earlier review are symptoms: breathlessness returning, ankles swelling, new tiredness, or a change in how you can manage stairs and hills. If any of those appear, contact the valve team rather than waiting for the twelve month scan. For your own echo, the best person to explain it is the cardiologist who has seen the images, so it is reasonable to ring and ask them to go through the report with you.

#5Ron Castellano(Joined Feb 2026 · 47 posts)October 5, 2026, 7:50 pm

Thank you Dr Voss. I rang the clinic and the nurse specialist read me the full report. She said the leak is "at the mild end of mild" and the same as it was on the scan before I left hospital, which nobody had told me. So not new, not growing.

I am going to try to take the twelve months at face value.

#6Marlene K(Joined Mar 2026 · 31 posts)October 12, 2026, 10:30 am

Ron, the "same as before you left hospital" bit is the most reassuring thing on this whole forum. Ask for the comparison every time, that is what I do now. It is the change they care about, not the word.