Combined Significant Aortic Stenosis and Mitral Regurgitation: Challenges in Timing and Type of Intervention

Alaour, Bashir; Nakase, Masaaki; Pilgrim, Thomas

doi:10.1016/j.cjca.2023.11.003

Cited by 4 publications

(2 citation statements)

References 101 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Algorithms for stable patients indicate that, in the presence of severe AS and significant/severe MR, TAVI should be performed, and MR should be medically treated and followed up. However, in cases of severe MR and moderate AS, if MR is the prognostically leading pathology, mitral intervention should be performed, followed by AS follow-up [ 94 ]. In the urgent setting, given the lack of evidence, no such recommendations exist in consensus documents or guidelines.…”

Section: Future Directionsmentioning

confidence: 99%

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Pyrpyris,

Dimitriadis,

Theofilis

et al. 2024

JCM

View full text Add to dashboard Cite

Structural heart disease is increasingly prevalent in the general population, especially in patients of increased age. Recent advances in transcatheter structural heart interventions have gained a significant following and are now considered a mainstay option for managing stable valvular disease. However, the concept of transcatheter interventions has also been tested in acute settings by several investigators, especially in cases where valvular disease comes as a result of acute ischemia or in the context of acute decompensated heart failure. Tested interventions include both the mitral and aortic valve, mostly evaluating mitral transcatheter edge-to-edge repair and transcatheter aortic valve implantation, respectively. This review is going to focus on the use of acute structural heart interventions in the emergent setting, and it will delineate the available data and provide a meaningful discussion on the optimal patient phenotype and future directions of the field.

show abstract

Section: Future Directionsmentioning

confidence: 99%

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Pyrpyris,

Dimitriadis,

Theofilis

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…Also, studies have revealed that up to 15% of patients diagnosed with severe AS also exhibit moderate or severe TR, underscoring the prevalence and clinical complexity of these concurrent conditions (4,5). Addressing both conditions requires a thorough assessment of valve anatomy and function, and understanding the underlying pathophysiological pathways to establish appropriate treatment methods and planning procedures (6,7,8).…”

Section: Introductionmentioning

confidence: 99%

Impact of Moderate to Severe Mitral and Tricuspid Valves Regurgitation after Transcatheter Aortic Valve Implantation: A Multicenter Retrospective Study

Abraham,

Botros,

Fath

et al. 2024

Preprint

View full text Add to dashboard Cite

Tricuspid regurgitation (TR) and mitral regurgitation (MR) are common valvular conditions encountered in patients undergoing transcatheter aortic valve implantation (TAVI). This retrospective study investigates the impact of moderate or severe TR and MR on all-cause mortality in one-year post-TAVI patients. Consecutive patients who underwent TAVI at our institution between 2012 and 2018 were identified. Patients were stratified into 2 groups based on valvular regurgitation severity: moderate/severe MR vs. no/mild MR, and moderate/severe TR vs. no/mild TR. Primary outcome was all-cause mortality at 1-year follow up, and secondary outcome was in-hospital death. Logistic regression analysis was conducted to assess the relationship between moderate/severe MR or TR and all-cause mortality at 1-year follow-up. We included a total of 1,071 patients who underwent TAVI with mean age 80.9 ± 8.6 years, 97% white, and 58.3% males. Moderate or severe MR group included 52 (4.88%) patients while mild or no MR group included 1,015 (95.12%) patients. There was no significant difference between both groups in TAVI procedure success rate (100% vs. 97.83%, p=0.283), in-hospital mortality (0 vs. 1.08%, p=0.450), or mortality at 1-year follow up (15.38% vs. 14.09%, p=0.794). In the logistic regression analysis, moderate or severe MR did not show significant correlation with all-cause mortality at 1-year follow up (OR 0.88, 95% CI [0.38 - 1.99], p=0.761). Moderate or severe TR group included 86 (8.03%) patients while mild or no TR group included 985 (91.97%) patients. There was no difference between both groups in TAVI procedure success (98.8% vs. 97.9%, p=0.54) or in-hospital mortality (0% vs. 1.1%, p=0.33). At 1-year follow up, patients with moderate or severe TR had higher mortality (26.7% vs. 13.2%, p=0.001) compared to patients with mild or no TR. In the logistic regression analysis, moderate or severe TR was correlated with higher all-cause mortality at 1-year (OR 1.89, 95% CI [1.07, 3.34], P=0.027). At 1 year follow up, moderate/severe TR, but not MR, is associated with higher mortality in patients underwent TAVI. Careful assessment of multi-valvular heart disease prior to the procedure is warranted.

show abstract

Impact of moderate or severe mitral and tricuspid valves regurgitation after transcatheter aortic valve replacement

Abraham,

Suppah,

Farina

et al. 2025

American Heart Journal

View full text Add to dashboard Cite

Combined Significant Aortic Stenosis and Mitral Regurgitation: Challenges in Timing and Type of Intervention

Cited by 4 publications

References 101 publications

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Impact of Moderate to Severe Mitral and Tricuspid Valves Regurgitation after Transcatheter Aortic Valve Implantation: A Multicenter Retrospective Study

Impact of moderate or severe mitral and tricuspid valves regurgitation after transcatheter aortic valve replacement

Contact Info

Product

Resources

About