Mild-to-moderate aortic stenosis independently increased the risk of acute hypoxemic respiratory failure (16.7% vs. 3.8%, aOR 4.38) following mitral transcatheter edge-to-edge repair.
Does the presence of mild-to-moderate aortic stenosis increase the risk of acute hypoxemic respiratory failure in patients undergoing mitral transcatheter edge-to-edge repair?
In patients undergoing mitral transcatheter edge-to-edge repair, coexisting mild-to-moderate aortic stenosis is independently associated with a more than four-fold increased risk of early post-procedural acute hypoxemic respiratory failure.
Absolute Event Rate: 0% vs 0%
ABSTRACT Background The coexistence of severe mitral regurgitation (MR) and mild‐to‐moderate aortic stenosis (AS) presents diagnostic and therapeutic challenges. Limited data exists on outcomes following mitral transcatheter edge‐to‐edge repair (M‐TEER) therapy in this patient population. Aims This study is aimed to evaluate clinical outcomes following M‐TEER in patients with mild‐to‐modearte AS compared with those without aortic stenosis. Methods A single‐center retrospective study was conducted on 238 patients who underwent M‐TEER therapy between January 2014 and December 2024. Patients with severe AS, cardiogenic shock, and failed or aborted cases were excluded. We compared patients with mild‐to‐moderate AS ( n = 30) to those without AS ( n = 208). Primary outcome: Acute hypoxemic respiratory failure (AHRF) within 24 h (SpO 2 ≤ 90% ≥ 30 min or need for O 2 /NIV/IMV, adjudicated as cardiogenic). Secondary outcomes: Post‐procedural in‐hospital mortality, acute kidney injury, hospital length of stay (LOS), 30‐day rate of heart failure hospitalization (HFH), and 30‐day rate of all‐cause readmission. Multivariable logistic regression was used to identify independent predictors of AHRF, hospital LOS, and 30‐day HFH. Results Following M‐TEER, the mild‐to‐moderate AS group experienced significantly higher rates of AHRF (16.7% vs. 3.8%, p = 0.0142; adjusted OR 4.38, 95% CI 1.36–14.61, p = 0.014). Within the parsimonious adjusted model, AS remained independently associated with AHRF, whereas the other included covariates were not. There was no significant difference in the 30‐day rate of all‐cause readmission, 30‐day rate of HFH, AKI, LOS, or in‐hospital mortality between groups. Conclusion In patients undergoing M‐TEER, the presence of mild‐to‐moderate AS is independently associated with an increased risk of early post‐procedural AHRF, without differences in other short‐term clinical outcomes. Given the single‐center retrospective design and the limited number of clinical events, these findings should be considered hypothesis‐generating and warrant validation in larger, prospective, multicenter studies.
Sonbol et al. (Thu,) reported a other. Mild-to-moderate aortic stenosis independently increased the risk of acute hypoxemic respiratory failure (16.7% vs. 3.8%, aOR 4.38) following mitral transcatheter edge-to-edge repair.