Clinical research

DOI: 10.4244/EIJ-D-22-01062

Impact of mitral regurgitation aetiology on the outcomes of transcatheter aortic valve implantation

Philipp Maximilian Doldi1,2, MD, MSc; Julius Steffen1,2, MD; Lukas Stolz1, MD; Julius Fischer1, MD; Thomas J. Stocker1,2, MD; Martin Orban1,2, MD; Hans Theiss1, MD; Konstantinos Rizas1,2, MD; Sebastian Sadoni3, MD; Christian Hagl3, MD; Steffen Massberg1,2, MD; Jörg Hausleiter1,2, MD; Daniel Braun1,2, MD, MBHA; Simon Deseive1,2, MD

Abstract

Background: Concomitant moderate/severe mitral regurgitation (MR) is observed in 17-35% of patients undergoing transcatheter aortic valve implantation (TAVI) and contributes to a worse prognosis. Studies analysing outcomes in patients undergoing TAVI with different MR aetiologies, including atrial functional MR (aFMR), are lacking.

Aims: We aimed to analyse outcomes and changes in MR severity in patients with aFMR, ventricular functional (vFMR) and primary mitral regurgitation (PMR) following TAVI.

Methods: We analysed all consecutive patients with at least moderate MR undergoing TAVI between January 2013 and December 2020 at the Munich University Hospital. Characterisation of MR aetiology was performed by detailed individual echocardiographic assessment. Three-year mortality, changes in MR severity and New York Heart Association (NYHA) Functional Class at follow-up were assessed.

Results: Out of 3,474 patients undergoing TAVI, 631 patients showed MR ≥2+ (172 with aFMR, 296 with vFMR, 163 with PMR). Procedural characteristics and endpoints were comparable between groups. The rate of MR improvement was 80.2% in aFMR patients, which was significantly higher compared to both other groups (vFMR: 69.4%; p=0.03; PMR: 40.8%; p<0.001). The estimated 3-year survival rates did not...

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Volume 19 Number 6
Aug 21, 2023
Volume 19 Number 6
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