+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Impact of moderate to severe mitral stenosis in patients undergoing transcatheter aortic valve replacement



Impact of moderate to severe mitral stenosis in patients undergoing transcatheter aortic valve replacement



International Journal of Cardiology 2019



In patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR), the impact of concomitant mitral stenosis (MS) remains unknown. The aim of this study was to determine the incidence and impact of moderate to severe MS in patients undergoing TAVR. The study included 2113 consecutive patients (mean age: 80 ± 9 years, mean STS: 6.4 ± 5.2%) who underwent TAVR in 2 centers. The presence of MS was defined as a mean transmitral gradient ≥ 5 mm Hg on baseline echocardiography in the absence of severe mitral regurgitation. Clinical events were prospectively collected in a dedicated TAVR database. A total of 157 patients (7.4%) had moderate to severe MS (mean gradient: 7.2 ± 2.8 mm Hg; degenerative origin in 88%). Patients with MS were younger, more frequently women, had a higher left ventricular ejection fraction and an increased rate of severe pulmonary hypertension (p < 0.02 for all). Thirty-day mortality was similar in both groups (MS: 3.8%; no MS: 5.5%, adjusted p = 0.34). At a mean follow-up of 3 ± 2 years, there were no differences between groups in mortality (MS: 35%, no MS: 36.2%, adjusted HR: 1.14, 95% CI: 0.86-1.51), or heart failure rehospitalization (MS: 21%, no MS: 21.7%; adjusted HR: 1.16, 95% CI: 0.81-1.67). Patients with MS exhibited a similar functional status at follow-up compared to those with no MS (NYHA I-II in 85% and 88% of patients, respectively, adjusted p = 0.20). About 7% of patients undergoing TAVR had concomitant moderate to severe MS. The presence of MS had no negative impact on early and mid-term clinical outcomes post-TAVR. These results suggest that TAVR is a valid alternative for treating patients with aortic stenosis in the presence of moderate to severe MS.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 066675363

Download citation: RISBibTeXText

PMID: 30967274

DOI: 10.1016/j.ijcard.2019.03.053


Related references

The impact of mitral stenosis on outcomes of aortic valve stenosis patient undergoing surgical aortic valve replacement or transcatheter aortic valve replacement. Journal of Interventional Cardiology 31(5): 655-660, 2018

Impact of preoperative moderate/severe mitral regurgitation on 2-year outcome after transcatheter and surgical aortic valve replacement: insight from the Placement of Aortic Transcatheter Valve (PARTNER) Trial Cohort A. Circulation 128(25): 2776-2784, 2014

The impact of prior stroke on the outcome of patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. Cardiovascular Revascularization Medicine 17(5): 322-327, 2017

Impact of right ventricular function on outcome of severe aortic stenosis patients undergoing transcatheter aortic valve replacement. American Heart Journal 184: 141-147, 2017

Does moderate mitral regurgitation impact early or mid-term clinical outcome in patients undergoing isolated aortic valve replacement for aortic stenosis?. European Journal of Cardio-Thoracic Surgery 24(2): 217-22; Discussion 222, 2003

Impact of transfemoral versus transapical access on mortality among patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. Cardiovascular Revascularization Medicine 17(5): 318-321, 2017

Impact of left ventricular diastolic function and survival in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. Plos One 13(5): E0196031, 2018

Impact of mitral regurgitation on clinical outcomes of patients with low-ejection fraction, low-gradient severe aortic stenosis undergoing transcatheter aortic valve implantation. Circulation. Cardiovascular Interventions 8(2): E001895, 2015

Prevalence and impact of preoperative moderate/severe tricuspid regurgitation on patients undergoing transcatheter aortic valve replacement. Catheterization and Cardiovascular Interventions 85(4): 677-684, 2015

Prevalence and Impact of Atrial Fibrillation in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: An Analysis From the SOURCE XT Prospective Multicenter Registry. Jacc. Cardiovascular Interventions 9(9): 937-946, 2017

Mitral valve repair versus replacement for moderate-to-severe mitral regurgitation in patients undergoing concomitant aortic valve replacement. Interactive Cardiovascular and Thoracic Surgery 18(1): 73-79, 2014

TCT-682 Impact of concomitant mitral regurgitation on mortality after transcatheter aortic valve replacement for severe aortic stenosis in high risk patients results from a prospective single center registry. Journal of the American College of Cardiology 66(15): B278-B279, 2015

Prevalence and Outcomes of Mitral Stenosis in Patients Undergoing Transcatheter Aortic Valve Replacement: Findings From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry. Jacc. Cardiovascular Interventions 11(7): 693-702, 2018

Prognostic significance of aortic valve gradient in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. Catheterization and Cardiovascular Interventions 90(7): 1175-1182, 2017

Cost-effectiveness of transcatheter aortic valve replacement compared with surgical aortic valve replacement in high-risk patients with severe aortic stenosis: results of the PARTNER (Placement of Aortic Transcatheter Valves) trial (Cohort A). Journal of the American College of Cardiology 60(25): 2683-2692, 2013