What is the clinical evidence from this study?

Study design: Observational. Population: Aortic stenosis with mitral regurgitation (n=65). Intervention: Transcatheter aortic valve implantation (TAVI) vs. Pre-procedure baseline. Primary outcome: Presence of mitral regurgitation (p=<0.001).

What does this research mean for the field?

Transcatheter aortic valve implantation is associated with a significant reduction in the prevalence and severity of concomitant mitral regurgitation, particularly among patients with severe regurgitation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 27, 2014Journal of the Saudi Heart AssociationOpen Access

The change in mitral regurgitation severity after trans-catheter aortic valve implantation

Q: What are the key findings of this study?

Transcatheter aortic valve implantation significantly reduced the prevalence of mitral regurgitation from 85.3% pre-procedure to 63.2% post-procedure (p < 0.001).

Q: What does this research mean for the field?

Transcatheter aortic valve implantation is associated with a significant reduction in the prevalence and severity of concomitant mitral regurgitation, particularly among patients with severe regurgitation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess the changes in mitral regurgitation severity following transcatheter aortic valve implantation in patients with aortic stenosis.

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Key result

TAVI is linked to a ~26% reduction in mitral regurgitation prevalence post-procedure.

P<0.001
n=65

Why the study?

Mitral regurgitation is frequently found in patients with aortic stenosis, but the change in MR severity following transcatheter aortic valve implantation was not well characterized.

Does transcatheter aortic valve implantation improve mitral regurgitation severity in patients with aortic stenosis?

Key Points

To assess the changes in mitral regurgitation severity following transcatheter aortic valve implantation in patients with aortic stenosis.
Assessed mitral regurgitation severity before and after transcatheter aortic valve implantation using transthoracic echocardiography in 65 successfully treated patients.
Evaluated procedural and clinical predictors of improvement, including valve type (CoreValve vs. Edwards SAPIEN), access route, operative risk (EuroScore), and regurgitation etiology.
The total proportion of patients with mitral regurgitation dropped from 85.3% (58 patients) pre-procedure to 63.2% (43 patients) post-procedure (p < 0.001), with vena contracta width decreasing from 0.47 ± 0.28 to 0.25 ± 0.21 cm (p = 0.043).
Mitral regurgitation significantly improved in 59.4% (19/32) of patients presenting with moderate-to-severe regurgitation and in 85.7% (12/14) presenting with severe regurgitation (p < 0.001).
Improvement rates did not significantly differ by valve type (54.2% CoreValve vs. 43.9% Edwards SAPIEN; p = 0.424), etiology (48.1% organic vs. 48.6% functional; p = 0.968), or approach (51.2% femoral vs. 41.7% apical; p = 0.457).

Study Design

Type

Observational (n=65)

Multicenter

Structured PICO

Does transcatheter aortic valve implantation improve mitral regurgitation severity in patients with aortic stenosis?

Population

65 patients with aortic stenosis undergoing transcatheter aortic valve implantation to assess changes in mitral regurgitation severity.

Exposure

Transcatheter aortic valve implantation (TAVI) using CoreValve or Edwards SAPIEN via femoral or apical approach

Outcome

Change in mitral regurgitation severity assessed by transthoracic echocardiography before and after the proceduresurrogate

Main Result

Absolute Event Rate: 63.2% vs 85.3%

p-value: p=<0.001

TAVI is associated with a significant reduction in concomitant mitral regurgitation severity, particularly in patients with severe baseline MR, independent of valve type or MR etiology.

Limitations

Findings regarding the lack of influence of MR etiology, valve type, and operative risk need confirmation in a larger multi-center study
Small sample size
Single-center design

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

MR reduction after TAVI in AS may aid selected patients; leaves open clinical impact without prospective trials.

Cite This Study

Almasood et al. (2014) conducted an observational in Aortic stenosis with mitral regurgitation (n=65). Transcatheter aortic valve implantation (TAVI) vs. Pre-procedure baseline was evaluated on Presence of mitral regurgitation (p=<0.001). Transcatheter aortic valve implantation significantly reduced the prevalence of mitral regurgitation from 85.3% pre-procedure to 63.2% post-procedure (p < 0.001).

synapsesocial.com/papers/6ab7733b8a3bf3eb9745d7b8 https://doi.org/10.1016/j.jsha.2014.05.002

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The change in mitral regurgitation severity after trans-catheter aortic valve implantation

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

The change in mitral regurgitation severity after trans-catheter aortic valve implantation

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider