scholarly journals WHAT PREOPERATIVE ECHOCARDIOGRAPHIC PARAMETERS CAN HELP PREDICT IMPROVEMENT OF SIGNIFICANT MITRAL REGURGITATION IN PATIENTS WITH CONCOMITANT SEVERE AORTIC STENOSIS UNDERGOING ISOLATED AORTIC VALVE REPLACEMENT?

2019 ◽  
Vol 35 (10) ◽  
pp. S133-S134
Author(s):  
E. Voisine ◽  
F. Beaupré ◽  
M. Marzouk ◽  
P. Voisine ◽  
M. Sénéchal
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Echocardiographic Parameters

scholarly journals Prognosis of persistent mitral regurgitation in patients undergoing transcatheter aortic valve replacement

2020 ◽  
Vol 109 (10) ◽  
pp. 1261-1270 ◽  
Author(s):  
Victor Mauri ◽  
Maria I. Körber ◽  
Elmar Kuhn ◽  
Tobias Schmidt ◽  
Christian Frerker ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Transcatheter Aortic Valve ◽  
The Impact

Abstract Objective The objective of this study was to assess imaging predictors of mitral regurgitation (MR) improvement and to evaluate the impact of MR regression on long-term outcome in patients undergoing transcatheter aortic valve replacement (TAVR). Background Concomitant MR is a frequent finding in patients with severe aortic stenosis but usually left untreated at the time of TAVR. Methods Mitral regurgitation was graded by transthoracic echocardiography before and after TAVR in 677 consecutive patients with severe aortic stenosis. 2-year mortality was related to the degree of baseline and discharge MR. Morphological echo analysis was performed to determine predictors of MR improvement. Results 15.2% of patients presented with baseline MR ≥ 3 +, which was associated with a significantly decreased 2-year survival (57.7% vs. 74.4%, P < 0.001). MR improved in 50% of patients following TAVR, with 44% regressing to MR ≤ 2 +. MR improvement to ≤ 2 + was associated with significantly better survival compared to patients with persistent MR ≥ 3 +. Baseline parameters including non-severe baseline MR, the extent of mitral annular calcification and large annular dimension (≥ 32 mm) predicted the likelihood of an improvement to MR ≤ 2 +. A score based on these parameters selected groups with differing probability of MR ≤ 2 + post TAVR ranging from 10.5 to 94.4% (AUC 0.816; P < 0.001), and was predictive for 2-year mortality. Conclusion Unresolved severe MR is a critical determinant of long term mortality following TAVR. Persistence of severe MR following TAVR can be predicted using selected parameters derived from TTE-imaging. These data call for close follow up and additional mitral valve treatment in this subgroup. Graphic abstract Factors associated with MR persistence or regression after TAVR

scholarly journals P752 Mitral regurgitation in patients with severe aortic stenosis: role of valvular calcification in the persistence of mitral regurgitation after aortic valve replacement

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Squeri ◽  
A Ferri ◽  
S Calvi ◽  
A Albertini ◽  
S Censi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Surgical Aortic Valve Replacement ◽  
Secondary Mitral Regurgitation ◽  
Mitral Apparatus ◽  
Severe Calcification

Abstract Introduction mitral regurgitation is often associated with severe aortic stenosis but the indications for its correction at the time of aortic valve surgery are still unclear. Despite the indication for mitral valve repair or replacement in the case of severe secondary mitral regurgitation, many patients are left untreated. This is due to the common belief that secondary mitral regurgitation mostly improves after the aortic valve is treated. Purpose the aim of the study is to investigate the prevalence and distribution of mitral calcifications, their role in the development of mitral regurgitation and in its reduction after aortic valve replacement. Methods we reviewed all patient’s records who underwent aortic valve replacement for aortic stenosis at our institution from 12/2014 to 12/2016. Pre and post-operative echocardiograms were reviewed by experienced echocardiographer. Patients were then divided into 4 categories (functional, mild, moderate and severe calcification) on the basis of the presence, distribuition and severity of calcification on the mitral apparatus. Results at the end 651 patients were collected and analyzed. Mean age was 74yo. 334 (51,4%) of them were males. Most patients (63,1%) had only mild mitral regurgitation but 147 (22,6%) of them had moderate or severe mitral regurgitation. The presences of moderate or severe calcification of the mitral apparatus resulted to be a risk factor for the presence of mitral regurgitation associated with aortic stenosis as shown in Table 1. After surgical aortic valve replacement less than 21% of the patients showed a reduction of the degree of mitral regurgitation. We found no statistical difference between groups about mitral regurgitation changes after aortic valve replacement. Conclusions Mitral regurgitation is a common finding in patients with severe aortic stenosis and it’s prevalence is higher in patients with mitral calcifications. Few patients, however showed a reduction in the degree of mitral regurgitation after surgical aortic valve replacement with no difference related to the severity of annular or leaflets calcifications. TABLE 1 Logistic regression for the presence of mitral regurgitation Mitral Regurgitation Change after Aortic Valve Replacement CALCIFICATION DEGREE OR C.I. 95% p Reduced p Unchanged p Increased p Functional 53(21%) 176(71%) 18(7%) Mild 1.244571 0.81 - 1.93 0.32 28(20%) 0.86 105(76%) 0.43 6(4%) 0.34 Moderate 1.637297 1.05 - 2.56 0.03* 25(17%) 0.41 109(76%) 0.34 9(6%) 0.86 Severe 2.369245 1.46 - 3.85 &lt;0.01* 29(25%) 0.48 78(68%) 0.67 7(6%) 0.86 OR= Odds Ratio; C.I.=Confidence Interval; Functional= no calcification; Mild, Moderate and Severe= degree of mitral annular and leaflets calcifications.

scholarly journals Selected Abstracts of the TEEPGI 2014 Workshop

2014 ◽  
Vol 2 (1) ◽  
pp. 42-48
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Mitral Leaflet ◽  
Axis View

ABSTRACT Mitral valve perforation is most commonly due to infective endocarditis. Iatrogenic mitral valve perforation following aortic valve replacement has not been described previously. A 57 years male patient presented with complaints of progressive dyspnea on exertion and occasional palpitations. A preoperative diagnosis of severe aortic stenosis, sclerodegenerative aortic valve with normal left ventricle function was made on transthoracic echocardiography. A coronary angiogram showed single vessel disease involving proximal left anterior descending artery causing 80% stenosis. The patient was planned for aortic valve replacement (AVR) and CABG. Pre bypass TEE showed bicuspid aortic valve, thick, calcified, severe aortic stenosis and normal left ventricle systolic function. Mitral valve was morphologically normal with mild central mitral regurgitation jet. Patient underwent CABG and AVR under cardiopulmonary bypass support. Post CPB TEE examination showed 2 jets of mitral regurgitation in midesophageal aortic long-axis view (Fig. 1). There was a mild central MR jet and an additional mild MR jet from the body of anterior mitral leaflet. Transgastric short axis view showed turbulence in the region of A1 scallop of anterior mitral leaflet. We present the intraoperative TEE images of the patient with a discussion on the role of TEE in detection of mitral valve perforation and surgical decision making.

Sign in / Sign up

Export Citation Format

Share Document