Predictors and Outcome Impact of Mitral Regurgitation in Transcatheter Aortic Valve Replacement. - 2021

Available in print through MWHC library: 2002 - present

BACKGROUND/PURPOSE: Several studies have reported that mitral regurgitation (MR) can improve following transcatheter aortic valve replacement (TAVR) alone using earlier generation valves. The purpose of this study was to determine the predictors and short-term outcome impact of MR in patients undergoing TAVR using all generation valves across all risk groups. CONCLUSIONS: Our study identifies clinical characteristics, which help identify patients who may require closer post-procedural follow-up and warrant possible staged mitral valve intervention post-TAVR across all risk groups. Copyright (c) 2020. Published by Elsevier Inc. METHODS/MATERIALS: In this retrospective, study from 2012 to 2020, we reviewed data on 1822 low, intermediate and high-risk patients who underwent TAVR. Included were 1266 patients with baseline MR who underwent transfemoral TAVR. Our primary outcome was persistence or worsening of baseline MR post-TAVR. Additional endpoints included an inpatient composite (intensive care unit length of stay >24 h, post-TAVR length of stay >2 days and inpatient death), 30-day composite (30-day death or readmission) and 1-year composite (1-year death or readmission). RESULTS: Of the 1266 patients included, 665 had significant baseline MR (>=moderate), which improved in 79.4% of patients (n=528). Female patients, those with lower body mass indices and those with higher right ventricular systolic pressures were more likely to have persistence or worsening of baseline MR. Patients whose baseline MR persisted or worsened, had higher rates (80.3 vs. 77.3%, p=0.0019) of our inpatient composite, higher rates (15.3% vs. 10.0%, p=0.0389) of our 30-day composite and higher rates (36.7% vs. 26.8%, p=0.0107) of our 1-year composite when compared to patients whose baseline MR improved post-TAVR.


English

1878-0938

10.1016/j.carrev.2020.12.032 [doi] S1553-8389(20)30818-6 [pii]


*Aortic Valve Stenosis
*Mitral Valve Insufficiency
*Transcatheter Aortic Valve Replacement
Aortic Valve Stenosis/dg [Diagnostic Imaging]
Aortic Valve Stenosis/su [Surgery]
Aortic Valve/dg [Diagnostic Imaging]
Aortic Valve/su [Surgery]
Echocardiography
Female
Humans
Mitral Valve Insufficiency/dg [Diagnostic Imaging]
Mitral Valve Insufficiency/su [Surgery]
Retrospective Studies
Risk Factors
Severity of Illness Index
Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
Treatment Outcome


MedStar Heart & Vascular Institute


Journal Article