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Objectives To assess the incidence and natural course of paravalvular leaks detected early after aortic valve replacement. Background Although the use of echocardiography has simplified the postoperative assessment of patients with aortic valve replacement, there are no data regarding the natural history of early detected paravalvular aortic leaks. Methods Eighty-four consecutive patients with aortic valve replacement were prospectively followed clinically every 6 months and by echocardiography early (11 ± 7 days), at midterm (27 ± 3 months), and late (63 ± 4 months) after aortic valve replacement. The competence of artificial valves was assessed by Doppler color flow mapping. Results Paraprosthetic leaks were detected in 40 (47.6%) aortic prostheses during the early study; the majority (90%) were small. All leaks remained unchanged during the follow-up period. Left ventricular dimensions and function did …