Significant mitral regurgitation in patients undergoing TAVR: Mechanisms and imaging variables associated with improvement.
Aged, 80 and over
Aortic Valve
/ diagnostic imaging
Echocardiography
/ methods
Female
Follow-Up Studies
Humans
Male
Mitral Valve Insufficiency
/ diagnostic imaging
Postoperative Complications
/ diagnostic imaging
Retrospective Studies
Severity of Illness Index
Transcatheter Aortic Valve Replacement
Treatment Outcome
aortic valve replacement
computed tomography
echocardiography
mitral regurgitation
Journal
Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
19
01
2019
accepted:
09
02
2019
pubmed:
6
3
2019
medline:
18
12
2019
entrez:
6
3
2019
Statut:
ppublish
Résumé
Significant mitral regurgitation (MR) is associated with poorer outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). Factors associated with MR improvement have not been studied thoroughly. Retrospective analysis of consecutive patients treated with TAVR with more than mild MR at baseline. MR evolution was assessed at 1-3 and 6-12 months after intervention. MR severity and mechanisms were assessed by echocardiography. Mitral annulus calcification (MAC) was quantified using preoperative cardiac CT. From 674 consecutive TAVR recipients, 78 with more than mild MR had a 6-12 months follow-up. Following TAVR, MR improved in 34 patients (43%), remained stable in 38 (49%) and worsened in 6 (8%). Patients with MR improvement had greater tenting area (141 ± 56 vs. 99 ± 40 mm Larger mitral valve tenting area was associated with more improvement of MR after TAVR whereas extensive MAC associated with leaflet restriction was associated with less improvement. This may help in the clinical decision-making process of TAVR candidates with concomitant MR.
Sections du résumé
BACKGROUND
Significant mitral regurgitation (MR) is associated with poorer outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). Factors associated with MR improvement have not been studied thoroughly.
METHODS
Retrospective analysis of consecutive patients treated with TAVR with more than mild MR at baseline. MR evolution was assessed at 1-3 and 6-12 months after intervention. MR severity and mechanisms were assessed by echocardiography. Mitral annulus calcification (MAC) was quantified using preoperative cardiac CT.
RESULTS
From 674 consecutive TAVR recipients, 78 with more than mild MR had a 6-12 months follow-up. Following TAVR, MR improved in 34 patients (43%), remained stable in 38 (49%) and worsened in 6 (8%). Patients with MR improvement had greater tenting area (141 ± 56 vs. 99 ± 40 mm
CONCLUSION
Larger mitral valve tenting area was associated with more improvement of MR after TAVR whereas extensive MAC associated with leaflet restriction was associated with less improvement. This may help in the clinical decision-making process of TAVR candidates with concomitant MR.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
722-731Subventions
Organisme : CIHR
ID : #FDN-143225
Pays : Canada
Informations de copyright
© 2019 Wiley Periodicals, Inc.