Key result
Management of concomitant severe aortic stenosis and significant mitral regurgitation relies on risk stratification, with double-valve surgery favored in low-to-intermediate risk patients and transcatheter approaches considered for high-risk patients.
Why the study?
Concomitant significant MR and severe AS negatively affects prognosis and creates challenges in assessing valve lesion severity and determining treatment allocation.
This review highlights that while significant MR complicates severe AS and worsens prognosis, TAVR often improves MR, and staged transcatheter therapies offer a feasible option for high-risk patients.
Risk stratification informs management of severe AS with significant MR; leaves open optimal transcatheter sequencing pending prospective trials.
Significant mitral regurgitation (MR), frequently seen in the presence of severe aortic stenosis (AS), results in an association that negatively affects prognosis and imposes particular challenges for both the assessment of the severity of valvular lesions and decisions regarding treatment allocation. This article reviews the available literature with regards to the assessment of MR and AS in the presence of both; surgical management and results in patients with concomitant AS and MR; the effect of MR on outcomes in patients undergoing transcatheter aortic valve replacement; the effect of transcatheter aortic valve replacement on MR severity; and percutaneous treatment for MR after transcatheter aortic valve implantation. The authors aim to provide assistance in the decision-making process to treat patients with either a higher-risk double-valve procedure or a simpler, but perhaps incomplete, single-valve option.
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Masson et al. (2021) conducted a review in Aortic Stenosis and Mitral Regurgitation. Surgery versus Percutaneous Therapies was evaluated. Management of concomitant severe aortic stenosis and significant mitral regurgitation relies on risk stratification, with double-valve surgery favored in low-to-intermediate risk patients and transcatheter approaches considered for high-risk patients.
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