TY  - BOOK
AU  - Asch, Federico M
AU  - Baker, Nevin C
AU  - Ben-Dor, Itsik
AU  - Didier, Romain
AU  - Escarcega, Ricardo O
AU  - Gaglia, Michael AJ
AU  - Gai, Jiaxiang
AU  - Kiramijyan, Starkis
AU  - Koifman, Edward
AU  - Magalhaes, Marco A
AU  - Minha, Sa'ar
AU  - Negi, Smita I
AU  - Okubagzi, Petros
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Impact of baseline mitral regurgitation on short- and long-term outcomes following transcatheter aortic valve replacement
SN  - 0002-8703
PY  - 2016///
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Mitral Valve Insufficiency/ep [Epidemiology]
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/dg [Diagnostic Imaging]
KW  - Aortic Valve Stenosis/ep [Epidemiology]
KW  - Cohort Studies
KW  - Comorbidity
KW  - Databases, Factual
KW  - Echocardiography
KW  - Female
KW  - Humans
KW  - Male
KW  - Mitral Valve Insufficiency/dg [Diagnostic Imaging]
KW  - Mortality
KW  - Prognosis
KW  - Proportional Hazards Models
KW  - Retrospective Studies
KW  - Severity of Illness Index
KW  - Survival Analysis
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - BACKGROUND: The prevalence of concomitant significant mitral regurgitation (MR) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) ranges from 2% to 33%. The impact of significant MR on post-TAVR outcomes remains controversial; CONCLUSIONS: Moderate or greater MR in patients undergoing TAVR is associated with a higher 30-day but not 1-year mortality. A majority of the patients demonstrated significant improvement in MR following TAVR; Copyright � 2016. Published by Elsevier Inc; METHODS: The data from a cohort of patients with symptomatic severe AS undergoing TAVR at out institution were retrospectively analyzed. The last transthoracic echocardiogram (TTE) before the index TAVR procedure was selected as the baseline assessment of the degree of MR. The total study cohort (N = 589) was divided into 2 groups: significant >moderate MR (n = 68) versus nonsignificant <moderate MR (n = 521) at baseline. The 2 groups were compared in regard to baseline, imaging, procedural, and postprocedural characteristics. In-hospital, 30-day, and 1-year outcomes were assessed. Multivariate Cox regression survival analyses were performed to test the independent effect of >moderate MR on mortality at short- and long-term follow-up periods; RESULTS: Patients with >moderate MR had a higher mortality rate versus patients with <moderate MR during the initial 30-day follow-up after TAVR (unadjusted log-rank P = .011, risk-adjusted P = .031, hazard ratio = 2.40, 95% CI 1.08-5.29). However, the mortality rates at 1-year follow-up postprocedure were similar between the 2 groups (unadjusted log-rank P = .553, risk-adjusted P = .331, hazard ratio = 0.70, 95% CI 0.35-1.43). Among the original >moderate group, 62.5% and 77.7% of patients had improved to <moderate MR at 30-day and 1-year follow-up, respectively
UR  - https://dx.doi.org/10.1016/j.ahj.2016.03.020
ER  -