Why the study?
Does aortic valve replacement improve functional moderate-to-severe mitral regurgitation in patients with severe aortic stenosis?
Does aortic valve replacement improve functional moderate-to-severe mitral regurgitation in patients with severe aortic stenosis?
In patients with severe aortic stenosis and moderate-to-severe functional mitral regurgitation, AVR alone improves MR in approximately half of patients, suggesting concurrent mitral intervention should be considered when specific adverse preoperative echocardiographic parameters are present.
AVR alone may improve functional MR in half of severe AS patients; leaves open which echo parameters best identify need for concurrent mitral intervention.
GOAL: The aim of this study was to show whether the concomitant functional mitral regurgitation in patients undergoing aortic valve replacement improves after this surgical procedure and to identify preoperative echocardiographic parameters that may influence the lack of improvement in mitral regurgitation (MR) after aortic valve replacement (AVR). MATERIAL AND METHODS: The study included 45 patients with severe aortic stenosis and concomitant moderate to severe (+2/+3)mitral regurgitation. RESULTS: The results of our study indicated an improvement in the degree of mitral regurgitation in 24 patients. The most prominent parameters responsible for the lack of improvement of mitral regurgitation in our study were LVIDd, ERO, RVol, pulmonary artery systolic pressure and left atrial diameter. Identification of echocardiographic predictors may assist in selection of patients for whom more aggressive surgical treatment is advised. CONCLUSION: Concomitant moderate to severe functional MR indicates that MV should be repaired or replaced at the time of aortic valve surgery where at least two of indicated predicted preoperative echocardiographic parameters are present.
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Šehović et al. (2015) studied this question.
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