Functional Mitral Regurgitation After Aortic Valve Replacement for Aortic Insufficiency

Boll, Griffin; Lyvers, Jeffrey; Chen, Frederick Y.; Cobey, Frederick C.

doi:10.1053/j.jvca.2018.02.028

Cited by 1 publication

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References 16 publications

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“…Most of the prior studies include patients with aortic stenosis and moderate FMR [ 17 , 18 , 19 ]. However, researchers also raise their concerns on the impact of different aortic valve etiology on long-term outcomes [ 20 ]. The pathophysiological mechanisms of aortic insufficiency and aortic stenosis in patients with FMR are different.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Moderate Functional Mitral Regurgitation during Aortic Valve Replacement: A Cohort Study

Tiemuerniyazi¹,

Fei²,

Song³

et al. 2023

Rev. Cardiovasc. Med.

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Background: Treatment of moderate functional mitral regurgitation (FMR) during aortic valve replacement (AVR) is controversial. This study aimed to evaluate the effect of different surgical strategies in patients with moderate FMR undergoing AVR. Methods: A total of 468 patients with moderate FMR undergoing AVR from January 2010 to December 2019 were retrospectively studied comparing 3 different surgical strategies, namely isolated AVR, AVR + mitral valve repair (MVr) and AVR + mitral valve replacement (MVR). Survival was estimated using the Kaplan-Meier method and compared with the log-rank test, followed by inverse probability treatment weighting (IPTW) analysis to adjust the between-group imbalances. The primary outcome was overall mortality. Results: Patients underwent isolated AVR (35.3%), AVR + MVr (30.3%), or AVR + MVR (34.4%). The median follow-up was 27.1 months. AVR + MVR was associated with better improvement of FMR during the early and follow-up period compared to isolated AVR and AVR + MVr (p < 0.001). Compared to isolated AVR, AVR + MVR increased the risk of mid-term mortality (hazard ratio [HR]: 2.13, 95% confidence interval [CI]: 1.01-4.48, p = 0.046), which was sustained in the IPTW analysis (HR: 4.15, 95% CI: 1.69-10.15, p = 0.002). In contrast, AVR + MVr showed only a tendency to increase the risk of follow-up mortality (HR: 1.63, 95% CI: 0.72-3.67, p = 0.239), which was more apparent in the IPTW analysis (HR: 2.54, 95% CI: 0.98-6.56, p = 0.054). Conclusions: In patients with severe aortic valve disease and moderate FMR, isolated AVR might be more reasonable than AVR + MVr or AVR + MVR.

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