Mitral and Aortic Regurgitation Following Transcatheter Aortic Valve Replacement

Overview

Journal Heart

Date 2016 Feb 25

PMID 26908096

Citations 5

Authors

Piotr Szymanski

Tomasz Hryniewiecki

Maciej Dabrowski

Danuta Sorysz

Janusz Kochman

Jan Jastrzebski

Tomasz Kukulski

Marian Zembala

Affiliations

Soon will be listed here.

Abstract

Objective: To analyse the impact of postprocedural mitral regurgitation (MR), in an interaction with aortic regurgitation (AR), on mortality following transcatheter aortic valve implantation (TAVI).

Methods: To assess the interaction between MR and AR, we compared the survival rate of patients (i) without both significant MR and AR versus (ii) those with either significant MR or significant AR versus (iii) with significant MR and AR, all postprocedure. 381 participants of the Polish Transcatheter Aortic Valve Implantation Registry (166 males (43.6%) and 215 females (56.4%), age 78.8±7.4 years) were analysed. Follow-up was 94.1±96.5 days.

Results: In-hospital and midterm mortality were 6.6% and 10.2%, respectively. Significant MR and AR were present in 16% and 8.1% patients, including 3.1% patients with both significant MR and AR. Patients with significant versus insignificant AR differed with respect to mortality (log rank p=0.009). This difference was not apparent in a subgroup of patients without significant MR (log rank p=0.80). In a subgroup of patients without significant AR, there were no significant differences in mortality between individuals with versus without significant MR (log rank p=0.44). Significant MR and AR had a significant impact on mortality only when associated with each other (log rank p<0.0001). At multivariate Cox regression modelling concomitant significant MR and AR were independently associated with mortality (OR 3.2, 95% CI 1.54 to 5.71, p=0.002).

Conclusions: Significant MR or AR postprocedure, when isolated, had no impact on survival. Combined MR and AR had a significant impact on a patient's prognosis.

Citing Articles

Rare Cause of Severe Mitral Regurgitation after TAVI: Case Report and Literature Review.

Moldovan H, Popescu B, Nechifor E, Badea A, Ciomaga I, Nica C Medicina (Kaunas). 2022; 58(4).

PMID: 35454303 PMC: 9031139. DOI: 10.3390/medicina58040464.

Causes, pattern, predictors, and prognostic implications of new hospitalizations after transcatheter aortic valve implantation: a long-term nationwide observational study.

Nilsson K, Buccheri S, Christersson C, Koul S, Nilsson J, Petursson P Eur Heart J Qual Care Clin Outcomes. 2021; 8(2):150-160.

PMID: 33831187 PMC: 8888128. DOI: 10.1093/ehjqcco/qcab026.

The Impact of Self-Expandable Transcatheter Aortic Valve Replacement on Concomitant Functional Mitral Regurgitation: A Comprehensive Engineering Analysis.

Caballero A, Mao W, McKay R, Sun W Struct Heart. 2021; 4(3):179-191.

PMID: 33728393 PMC: 7958485. DOI: 10.1080/24748706.2020.1740365.

The impact of balloon-expandable transcatheter aortic valve replacement on concomitant mitral regurgitation: a comprehensive computational analysis.

Caballero A, Mao W, McKay R, Sun W J R Soc Interface. 2019; 16(157):20190355.

PMID: 31409236 PMC: 6731489. DOI: 10.1098/rsif.2019.0355.

POL-TAVI - Polish Registry of Transcatheter Aortic Valve Implantation - simple tool, great value, rationale and design.

Zembala-John J, Wilczek K, Tobota Z, Chodor P, Ciesla D, Jazwiec T Kardiochir Torakochirurgia Pol. 2017; 13(4):309-315.

PMID: 28096826 PMC: 5233759. DOI: 10.5114/kitp.2016.64870.

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