The features of the morphology of paravalvular insufficiency (PVI) were studied on the basis of analysis of 5,113 prosthetic replacements of the heart valves. From the clinical results and noninvasive and invasive data the authors revealed the peculiarities of the disorders of hemodynamics and functional condition of patients with PVI. Information on the specific features and the results of 35 repeated operations in PVI are discussed. Analysis showed 26.4% survival among patients 5 years after surgery. Bearing in mind the severity of the complication the authors emphasize the importance of its prevention.