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

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Citation: Cardiovascular Revascularization Medicine. 32:35-40, 2021 11.PMID: 33436346Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 OutcomeYear: 2021 Local holdings: Available in print through MWHC library: 2002 - presentISSN:

1878-0938

Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: 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.All authors: Green SJ, Medranda GA, Schwartz ROriginally published: Cardiovascular Revascularization Medicine. 2020 Dec 30Fiscal year: FY2022Fiscal year of original publication: FY2021Digital Object Identifier:

https://dx.doi.org/10.1016/j.carrev.2020.12.032

Date added to catalog: 2021-02-17

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	33436346	Available		33436346

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.

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