Key result
TAVR improves MR in ~65% of patients, though significant baseline MR predicts more HF readmissions.
Why the study?
Clinical outcomes of patients with severe aortic valve stenosis and concomitant mitral regurgitation undergoing TAVR needed to be described.
Does transcatheter aortic valve replacement (TAVR) improve survival and reduce heart failure readmissions in patients with severe aortic valve stenosis and concomitant significant mitral regurgitation?
Does transcatheter aortic valve replacement (TAVR) improve survival and reduce heart failure readmissions in patients with severe aortic valve stenosis and concomitant significant mitral regurgitation?
In patients undergoing TAVR, concomitant significant mitral regurgitation improves in the majority of cases and does not negatively impact long-term survival, though it is associated with higher rates of heart failure readmission.
Significant residual MR post-TAVR may increase HF readmissions; leaves open whether staged mitral intervention improves outcomes.
Objectives To describe the clinical outcomes of patients with severe aortic valve stenosis (AS) and concomitant mitral regurgitation (MR) undergoing transcatheter aortic valve replacement (TAVR) Methods A propensity‐score matched analysis including 267 patients who underwent TAVR between 2009 and 2023. Information on pre‐, intra‐, and postoperative variables was collected. The main outcomes were survival and freedom from readmission for heart failure on long term follow‐up comparing the group with significant MR (sMR) (moderate–severe) vs. the control group. Results The prevalence of sMR was 22%. TAVR improved the severity of MR in 65% of the patients. There were no significant differences on the main early postoperative outcomes. sMR was not associated with a lower survival on long‐term follow‐up but readmission for heart failure was higher in this group. Conclusions MR is highly prevalent in patients undergoing TAVR. The procedure has a beneficial effect on the severity of concomitant MR. sMR was not associated with a higher mortality in long‐term follow‐up, patients with sMR experience a significant improvement in symptoms after TAVR although sMR was associated with higher heart failure readmissions.
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Nunez–Ordonez et al. (2026) studied this question. TAVR improved mitral regurgitation severity in 65% of patients, but those with significant MR had higher heart failure readmissions despite no difference in long-term survival.
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