Mitral Regurgitation After Transcatheter Aortic Valve Replacement

Cortés, Carlos; Amat‐Santos, Ignacio J.; Nombela‐Franco, Luis; Muñoz-García, Antonio J.; Gutiérrez‐Ibañes, Enrique; Hernández, José M. de la Torre; Córdoba-Soriano, Juan G.; Jimenez-Quevedo, Pilar; Hernández-García, José M.; González‐Mansilla, Ana; Ruano, Javier; Jiménez-Mazuecos, Jesús; Castrodeza, Javier; Tobar, Javier; Islas, Fabián; Revilla, Ana; Puri, Rishi; Puerto, Ana; Gómez, Itzíar; Rodés‐Cabau, Josep; Román, José Alberto San

doi:10.1016/j.jcin.2016.05.025

Cited by 117 publications

(51 citation statements)

References 28 publications

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“…Significant baseline mitral regurgitation (MR) was seen in 117 of 1110 (16%) patients undergoing TAVR and was associated with a 3.5‐fold increase in 6‐month mortality (35 vs 10%) . After TAVR, the degree of MR improved in 60%.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter aortic valve replacement: The year in review 2016

Harjai

Grines

Paradis

et al. 2017

J Interven Cardiology

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Transcatheter aortic valve replacement (TAVR) continued to make major strides in 2016, simultaneously expanding its application to lower risk patients as well as more technically challenging subsets of patients with aortic stenosis (AS). The two major accomplishments this year were the establishment of TAVR as the preferred treatment strategy over surgical aortic valve replacement (SAVR) in intermediate risk patients, and initial signals that TAVR and SAVR may be clinically equivalent in low-risk populations. Meanwhile, there is continued expansion of TAVR to challenging clinical subsets (bicuspid aortic valve [BAV], patients with concomitant advanced coronary artery disease [CAD], and failed surgical bioprostheses), and encouraging initial experiences with newer transcatheter heart valve systems. This paper summarizes the major research studies published on TAVR in 2016.

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Section: Introductionmentioning

confidence: 99%

Transcatheter aortic valve replacement: The year in review 2016

Harjai

Grines

Paradis

et al. 2017

J Interven Cardiology

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“…C. Cortés и соавт. выделили следующие независимые предикторы персистирования МР после транскатетерной замены АК: кальцификация митрального кольца (более ⅓ периметра кольца), кальцификация створок (депозиты кальция обеих створок), диаметр митрального кольца более 35,5 мм [11]. Однако органические изменения МК не позволяют в полной мере делать выводы о течении функциональной митральной недостаточности [10,23].…”

Section: изменения со стороны митрального клапанаunclassified

Assessment of the predictors of persistence/progression of functional mitral insufficiency in patients undergoing the interventional treatment of aortic valve diseases

Skopin¹,

Slivneva²,

Latyshev³

et al. 2019

PKiK

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Mitral insufficiency usually accompanies numerous aortic valve diseases. At present, concomitant pronounced mitral regurgitation remains a fairly urgent problem in the transcatheter treatment of aortic valve diseases. During the postoperative period of transcatheter aortic valve replacement, mitral insufficiency tends to decrease in majority of the patients; however, in certain patients, mitral insufficiency persists as well as progresses, highlighting the advantages of this approach over open two-valve surgery. This article presents an analysis of research devoted to functional mitral insufficiency in patients undergoing the interventional treatment of aortic valve diseases. This study included high-risk patients (according to the STS scale of operational risk ≥8%), representing an older age group with a broad spectrum of comorbid pathologies. Some cases were categorised as the New York Heart Association functional class IV, presented with pronounced systolic dysfunction of the left ventricle or were considered inoperable. Based on the systematic review of eight studies, predictors of potential mitral insufficiency progression were identified, and treatment algorithms for this category of patients were studied for the interventional treatment of aortic valve disease. The intervention aims to optimise long-term prognosis, both in open surgery and minimally invasive interventions. The results of the present study will help improve immediate and long-term postoperative outcomes of the interventional treatment of aortic valve diseases. Determining the prognostic development of mitral regurgitation will help select the best management tactics for this complex group of patients, thereby improving treatment outcomes and long-term prognosis of both open surgery and minimally invasive interventions.Received 26 June 2019. Revised 23 August 2019. Accepted 26 August 2019.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.

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“…The prevalence of those with at least moderate mitral regurgitation undergoing TAVI can be up to 33% (21), with an increased mortality associated with this. However, in those with functional MR not due to intrinsic valve or apparatus disease, the majority experience a significant improvement in the degree of MR after TAVI (21, 22). Alternatively, a very large mitral annulus (>35.5 mm), calcification of the mitral apparatus and intrinsic valve leaflet dysfunction have been reported as independent predictors of persistent MR after TAVI (22).…”

Section: Peri-procedural and General Considerations In The Use Of Toementioning

confidence: 99%

“…However, in those with functional MR not due to intrinsic valve or apparatus disease, the majority experience a significant improvement in the degree of MR after TAVI (21, 22). Alternatively, a very large mitral annulus (>35.5 mm), calcification of the mitral apparatus and intrinsic valve leaflet dysfunction have been reported as independent predictors of persistent MR after TAVI (22). Therefore, the ability to identify mitral pathology pre-procedurally may help guide decisions regarding the appropriateness of THV implantation as opposed to open surgical treatment of both the aortic and mitral dysfunction.…”

Section: Peri-procedural and General Considerations In The Use Of Toementioning

confidence: 99%

3D transoesophageal echocardiography in the TAVI sizing arena: should we do it and how do we do it?

Bleakley¹,

Eskandari²,

Monaghan³

2017

Echo Research and Practice

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Transcatheter aortic valve implantation (TAVI) was initially proven as an alternative to valve replacement therapy in those beyond established risk thresholds for conventional surgery. With time the technique has been methodically refined and offered to a progressively lower risk cohort, and with this evolution has come that of the significant imaging requirements of valve implantation. This review discusses the role of transoesophageal echocardiography (TOE) in the current TAVI arena, aligning it with that of cardiac computed tomography, and outlining how TOE can be used most effectively both prior to and during TAVI in order to optimise outcomes.

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Mitral Regurgitation After Transcatheter Aortic Valve Replacement

Cited by 117 publications

References 28 publications

Transcatheter aortic valve replacement: The year in review 2016

Transcatheter aortic valve replacement: The year in review 2016

Assessment of the predictors of persistence/progression of functional mitral insufficiency in patients undergoing the interventional treatment of aortic valve diseases

3D transoesophageal echocardiography in the TAVI sizing arena: should we do it and how do we do it?

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