Key result
Preoperative LA diameter >50 mm linked to ~4.7-fold higher odds of persistent post-mitral surgery AR.
Why the study?
There is no clear finding on the course of coexisting aortic regurgitation after treatment of mitral regurgitation.
Cohort (n=65)
No
May inform risk stratification but should not yet change mitral surgery practice; leaves open need for prospective validation.
BACKGROUND: There is no clear finding on the course of coexisting aortic regurgitation (AR) after treatment of mitral regurgitation (MR). We investigated the effect of mitral surgery for MR on coexisting AR. METHODS: Between January 2008 and December 2016, 75 patients underwent mitral surgery for MR coexisting mild AR. Of these, 65 patients who were available to follow-up postoperative echocardiographic tests 1 year after surgery were included in the present study. Patients were divided into two groups according to the degree of postoperative AR. We investigated the predictive factors for continued AR and perioperative cardiac function. RESULTS: In all, 22 patients' AR improved and became less than mild and 43 patients' persisted at mild or increased. The predictive factor for continued AR was left atrial diameter >50 mm (P = 0.021, odds ratio = 4.739, 95% confidence interval: 1.259-17.846) in multivariate logistic regression analysis. No patients underwent reoperation for continued AR in both groups. However, one patient was rehospitalized for heart failure in the continued AR group. CONCLUSION: Left atrial diameter may be an important prognostic factor for continued AR after mitral surgery for MR. MR with mild AR should be treated as soon as before the left atrium expands.
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Hachiro et al. (2019) conducted a cohort in Mitral regurgitation with coexisting mild aortic regurgitation (n=65). Left atrial diameter >50 mm vs. Left atrial diameter ≤50 mm was evaluated on Continued aortic regurgitation (persisted at mild or increased) 1 year after surgery (OR 4.739, 95% CI 1.259-17.846, p=0.021). A preoperative left atrial diameter >50 mm significantly increased the odds of continued aortic regurgitation 1 year after mitral surgery for mitral regurgitation (OR 4.739).
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