{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T16:06:37Z","timestamp":1777737997009,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T00:00:00Z","timestamp":1567987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"LSI Solutions","award":["Dr. Shah reports receiving research funding"],"award-info":[{"award-number":["Dr. Shah reports receiving research funding"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Objective: Our study investigates the incidence, cumulative incidence, natural history, and factors associated with intraoperative paravalvular leak (PVL) and the development of a postoperative PVL in a contemporary consecutive cohort of patients following surgical aortic valve replacement. Methods: A total of 636 patients underwent surgical aortic valve replacement from 2006 to 2016; 410 (64.5%) underwent minimally invasive aortic valve replacement and 226 (35.5%) underwent conventional aortic valve replacement. Primary outcomes were the incidence of intraoperative PVL and cumulative incidence of postoperative PVL. Secondary outcomes were the incidence of in-hospital and long-term death and need for reoperation. Results: The overall incidence of intraoperative PVL was 1.4% (95% confidence interval [CI]: 1% to 3%). All intraoperative PVLs developed in the hand-tied group. The overall incidence of postoperative PVL was 5.3% (95% CI: 4% to 7%). In the univariable and multivariable analyses, postoperative renal failure was the only factor significantly associated with the development of a postoperative PVL. Conclusions: The incidence of intraoperative PVL is low. Cumulative incidence of postoperative PVL was 3.1% (95% CI: 1.0% to 13.6%), 4.3% (95% CI: 1.3% to 16.5%), and 5.0% (95% CI: 1.4% to 17.9%) at 1, 3, and 5 years, respectively. All intraoperative PVLs occurred with hand-tied knots. A larger cohort may identify additional risk factors.<\/jats:p>","DOI":"10.1177\/1556984519874806","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T07:11:07Z","timestamp":1568013067000},"page":"519-530","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Incidence, Natural History, and Factors Associated With Paravalvular Leak Following Surgical Aortic Valve Replacement"],"prefix":"10.1177","volume":"14","author":[{"given":"Vishal N.","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Institute for Medical Research, Wynnewood, PA, USA"},{"name":"Department of Cardiothoracic Surgery, Lankenau Medical Center, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oleg I.","family":"Orlov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Institute for Medical Research, Wynnewood, PA, USA"},{"name":"Department of Cardiothoracic Surgery, Lankenau Medical Center, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cinthia P.","family":"Orlov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Institute for Medical Research, Wynnewood, PA, USA"},{"name":"Department of Cardiothoracic Surgery, Lankenau Medical Center, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"Buckley","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Institute for Medical Research, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serge","family":"Sicouri","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Institute for Medical Research, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Takebe","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Medical Center, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew P.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Medical Center, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott M.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Medical Center, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstadinos A.","family":"Plestis","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Medical Center, Wynnewood, PA, 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