Key result
Transcatheter aortic valve implantation significantly reduced mitral regurgitation vena contracta width from 5.9 mm at baseline to 3.2 mm at 12 months (p=0.00004).
Why the study?
Mitral regurgitation of varying degrees and mechanisms is common in patients with aortic stenosis and shows different improvement after TAVI.
Does transcatheter aortic valve implantation improve mitral complex geometry and reduce mitral regurgitation in patients with severe aortic stenosis and moderate or severe mitral regurgitation?
Observational (n=31)
No
Does transcatheter aortic valve implantation improve mitral complex geometry and reduce mitral regurgitation in patients with severe aortic stenosis and moderate or severe mitral regurgitation?
Absolute Event Rate: 3.2% vs 5.9%
p-value: p=0.00004
TAVI significantly improves mitral valve complex function and reduces the severity of concomitant mitral regurgitation in patients with severe aortic stenosis.
TAVI may reduce MR via mitral geometry changes in severe AS; leaves open durability and need for RCTs before practice change.
Introduction: Mitral regurgitation (MR) of varying degrees and mechanisms is a common finding in patients with aortic stenosis with different improvement after transcatheter aortic valve implantation (TAVI).Aim: To evaluate the impact of TAVI on mitral complex geometry and the degree of MR.Material and methods: A total of 31 patients (29.0%males) with severe aortic stenosis and moderate or severe MR at the baseline who underwent TAVI were included in this study.Clinical and echocardiographic characteristics were determined at baseline and at 6 and 12 months.Results: After TAVI, decrease of MR vena contracta width (p = 0.00002, p = 0.00004), aorto-mural mitral annulus diameter (p = 0.00008, p = 0.02), increase of mitral annular plane systolic excursion (p = 0.0004, p = 0.0003), left ventricular stroke volume (p = 0.0003, p = 0.0004), ejection fraction (p = 0.0004, p = 0.01) and decrease of major dimension of left ventricle in three chamber view (p = 0.05, p = 0.002) were observed in patients at both time points.Additionally, we observed a decrease of distance between the head of the papillary muscles (p = 0.003) at 6 months and a decrease of left atrium volume index (p = 0.01) and systolic pulmonary artery pressure (p = 0.01) at 12 months.Conclusions: Patients with moderate or severe MR undergoing TAVI achieved significant improvement of mitral valve complex function resulting in the reduction of MR degree.
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Sorysz et al. (2020) conducted an observational in Severe aortic stenosis and moderate or severe mitral regurgitation (n=31). Transcatheter aortic valve implantation (TAVI) vs. Baseline (pre-TAVI) was evaluated on Vena contracta (VC) width at 12 months (p=0.00004). Transcatheter aortic valve implantation significantly reduced mitral regurgitation vena contracta width from 5.9 mm at baseline to 3.2 mm at 12 months (p=0.00004).
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