Author + information
- Akihiro Kobayashi1,
- Sean Sliman2,
- Mohamad Lazkani3,
- Shishir Murarka4,
- Soundos Moualla1,
- Divya Ratan Verma3,
- Michael Morris3 and
- Ashish Pershad1
Patients undergoing trans-catheter aortic valve replacement (TAVR) can have concomitant mitral regurgitation (MR). It has been shown that surgical aortic valve replacement can improve the severity of concomitant MR. However the impact of TAVR on concomitant MR has not been fully elucidated.
We performed a retrospective analysis of patients with severe symptomatic aortic stenosis who underwent TAVR from January 2014 to June 2016. Pre- and post-procedural transthoracic echocardiograms (TTE) were reviewed to identify patients whose MR improved more than one grade after TAVR. Baseline clinical characteristics were recorded. In addition, 30-day readmission rate, in-hospital as well as 6-month major adverse cardiac events (MACE) such as mortality, cardiac arrest, myocardial infarction, and stroke were recorded and compared between the two groups.
After excluding 28 patients who did not have MR on pre-procedural TTE, a total 182 patients were included in the final analysis, of which MR improved in 99 patients (54.4%) post TAVR. There was a trend for a lower pre-procedural left ventricular ejection fraction in patients with improved MR (55% [40-60] vs. 55% [45-60], p=0.15). History of atrial fibrillation was similar between the two groups (18.2% vs. 18.1%, p=0.98). There was a trend for a lower in-hospital MACE in patients with improved MR (4.0% vs. 7.2%, p=0.34). Patients with improved MR had a lower, statistically albeit insignificant, rate of 30-day admission (7.1% vs. 15.7%, p=0.065). Although, it did not reach a statistical significance, patients with improved MR had a lower 6-month MACE (15.2% vs. 24.1%, p=0.12).
In our cohort of patients with concomitant MR who underwent TAVR, MR improved in 54.4% of patients after TAVR. Although it did not reach a statistical significance, patients with improved MR had a lower 30-day readmission. There was a trend for a lower in-hospital and 6-month MACE in patients with improved MR.
STRUCTURAL: Valvular Disease: Aortic