What does this research mean for the field?

In patients with normal left ventricular ejection fraction, moderate mitral regurgitation associated with severe aortic stenosis typically regresses early after aortic valve replacement, with mitral calcifications and left atrial dilation serving as predictive factors for fixed mitral regurgitation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 1, 2003Clinical CardiologyOpen Access

Factors determining early improvement in mitral regurgitation after aortic valve replacement for aortic valve stenosis: A transthioracic and transesophageal prospective study

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Why the study?

Does aortic valve replacement improve coexisting mitral regurgitation in patients with severe aortic stenosis?

Population

30 adult patients referred for aortic valve replacement for severe aortic stenosis. Excluded: severe aortic…

Design

Cohort

Follow-up

19 ± 10 days

Authors

STSophie Tassan‐ManginaCentre Hospitalier Universitaire de Reims DMDamien MetzCentre Hospitalier Universitaire de Reims PNPierre NazeyrollasCentre Hospitalier Universitaire de Reims

Discussion

Member takes

Implication

Moderate MR may regress after AVR in severe AS with normal LVEF; hypothesis-generating and should not yet change practice on concomitant mitral surgery.

Structured PICO

Does aortic valve replacement improve coexisting mitral regurgitation in patients with severe aortic stenosis?

Population

30 adult patients (18 men, 12 women, mean age 68 ± 8 years) referred for aortic valve replacement for severe aortic stenosis. Excluded: severe aortic regurgitation, unstable hemodynamic state, arrhythmia, contraindication to surgery or TEE, and patients requiring mitral valve or mitral annulus surgery.

Intervention

Aortic valve replacement (24 mechanical prostheses, 6 bioprostheses)

Outcome

Frequency and severity of mitral regurgitation before and after aortic valve replacement, and determinants of its postoperative evolution, measured by transthoracic and transesophageal echocardiography at 19 ± 10 days postoperativelysurrogate

In patients with severe aortic stenosis and normal LVEF, moderate mitral regurgitation regresses early after aortic valve replacement, suggesting concomitant mitral surgery may not be necessary unless fixed anatomical abnormalities like calcifications are present.

Limitations

MR was usually mild, assessed by a semiquantitative tool (maximal area of the mitral regurgitant jet)
Early postoperative echocardiography may not fully appreciate LV remodeling and its long-term impact on MR evolution

Cite This Study

Tassan‐Mangina et al. (2003) studied this question.

synapsesocial.com/papers/6a1d1c3e1c2cbcb15c5dc747 https://doi.org/10.1002/clc.4960260306

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Implication

Moderate MR may regress after AVR in severe AS with normal LVEF; hypothesis-generating and should not yet change practice on concomitant mitral surgery.

Factors determining early improvement in mitral regurgitation after aortic valve replacement for aortic valve stenosis: A transthioracic and transesophageal prospective study

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Factors determining early improvement in mitral regurgitation after aortic valve replacement for aortic valve stenosis: A transthioracic and transesophageal prospective study

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

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