Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation
<i>Background and Objectives</i>: Associated mitral regurgitation (MR) is frequently observed during transcatheter aortic valve implantation (TAVI). The progression of moderate MR remains undetermined, given uncertain clinical significance and natural history. This study aims to assess t...
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2025-04-01
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| author | Massimo Baudo Serge Sicouri Francesco Cabrucci Yoshiyuki Yamashita Dimitrios E. Magouliotis Sarah M. Carnila Sandra V. Abramson Katie M. Hawthorne Harish Jarrett Roberto Rodriguez Scott M. Goldman Paul M. Coady Eric M. Gnall William A. Gray Sandro Gelsomino Basel Ramlawi |
| author_facet | Massimo Baudo Serge Sicouri Francesco Cabrucci Yoshiyuki Yamashita Dimitrios E. Magouliotis Sarah M. Carnila Sandra V. Abramson Katie M. Hawthorne Harish Jarrett Roberto Rodriguez Scott M. Goldman Paul M. Coady Eric M. Gnall William A. Gray Sandro Gelsomino Basel Ramlawi |
| author_sort | Massimo Baudo |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Associated mitral regurgitation (MR) is frequently observed during transcatheter aortic valve implantation (TAVI). The progression of moderate MR remains undetermined, given uncertain clinical significance and natural history. This study aims to assess the evolution of moderate MR following TAVI. <i>Materials and Methods</i>: Between 2018 and 2023, 1476 patients underwent TAVI. We excluded those with previous aortic or mitral valve interventions, endocarditis, concomitant percutaneous coronary intervention, or emergent procedures. Patients with severe aortic or tricuspid regurgitation or significant mitral stenosis were excluded. Ultimately, only patients with moderate MR were included, resulting in a final population of 154 patients. <i>Results</i>: Mean age was 81.4 ± 7.8 years, 48.1% (74/154) were female, and 48.1% (74/154) were functional MR. There was one surgical conversion due to annular rupture. Thirty-day mortality was 1.9% (3/154). Postoperative echocardiography showed 38 (24.7%) patients with none/trace MR, 91 (59.1%) with mild MR, 22 (14.3%) with moderate MR, and 3 (1.9%) with severe MR. Finally, according to the echocardiographic follow-up [median follow-up 1.0 (IQR: 0.1–1.2) years], 20.1% (31/154) had no/trace MR, 39.6% (61/154) had mild MR, 35.7% (55/154) had moderate MR, and 4.5% (7/154) had severe MR. Overall, 67 (43.5%) patients had any MR grade progression, 62 (40.3%) had stable disease, and 25 (16.2%) had any MR grade reduction at the last follow-up from the operation. No difference in MR evolution was seen between functional and primary MR. <i>Conclusions</i>: Concomitant moderate MR during TAVI has a variable evolution over time. A more detailed characterization of patients with preoperative moderate MR undergoing TAVI is necessary to identify those with a disease progression risk. |
| format | Article |
| id | doaj-art-e9aabe076e4e4b9da5377382c13cfd86 |
| institution | DOAJ |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-e9aabe076e4e4b9da5377382c13cfd862025-08-20T03:13:50ZengMDPI AGMedicina1010-660X1648-91442025-04-0161468610.3390/medicina61040686Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve ImplantationMassimo Baudo0Serge Sicouri1Francesco Cabrucci2Yoshiyuki Yamashita3Dimitrios E. Magouliotis4Sarah M. Carnila5Sandra V. Abramson6Katie M. Hawthorne7Harish Jarrett8Roberto Rodriguez9Scott M. Goldman10Paul M. Coady11Eric M. Gnall12William A. Gray13Sandro Gelsomino14Basel Ramlawi15Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USADepartment of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USADepartment of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USADepartment of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USADepartment of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USADepartment of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USADepartment of Interventional Cardiology, Cardiovascular Imaging Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA 19096, USADepartment of Interventional Cardiology, Cardiovascular Imaging Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA 19096, USADepartment of Interventional Cardiology, Cardiovascular Imaging Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA 19096, USADepartment of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA 19096, USADepartment of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA 19096, USADepartment of Interventional Cardiology, Lankenau Heart Institute, Main Line Health, Wynnewood, PA 19096, USADepartment of Interventional Cardiology, Lankenau Heart Institute, Main Line Health, Wynnewood, PA 19096, USADepartment of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USACardiovascular Research Institute Maastricht—CARIM, Maastricht University Medical Centre, 6229 ER Maastricht, The NetherlandsDepartment of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USA<i>Background and Objectives</i>: Associated mitral regurgitation (MR) is frequently observed during transcatheter aortic valve implantation (TAVI). The progression of moderate MR remains undetermined, given uncertain clinical significance and natural history. This study aims to assess the evolution of moderate MR following TAVI. <i>Materials and Methods</i>: Between 2018 and 2023, 1476 patients underwent TAVI. We excluded those with previous aortic or mitral valve interventions, endocarditis, concomitant percutaneous coronary intervention, or emergent procedures. Patients with severe aortic or tricuspid regurgitation or significant mitral stenosis were excluded. Ultimately, only patients with moderate MR were included, resulting in a final population of 154 patients. <i>Results</i>: Mean age was 81.4 ± 7.8 years, 48.1% (74/154) were female, and 48.1% (74/154) were functional MR. There was one surgical conversion due to annular rupture. Thirty-day mortality was 1.9% (3/154). Postoperative echocardiography showed 38 (24.7%) patients with none/trace MR, 91 (59.1%) with mild MR, 22 (14.3%) with moderate MR, and 3 (1.9%) with severe MR. Finally, according to the echocardiographic follow-up [median follow-up 1.0 (IQR: 0.1–1.2) years], 20.1% (31/154) had no/trace MR, 39.6% (61/154) had mild MR, 35.7% (55/154) had moderate MR, and 4.5% (7/154) had severe MR. Overall, 67 (43.5%) patients had any MR grade progression, 62 (40.3%) had stable disease, and 25 (16.2%) had any MR grade reduction at the last follow-up from the operation. No difference in MR evolution was seen between functional and primary MR. <i>Conclusions</i>: Concomitant moderate MR during TAVI has a variable evolution over time. A more detailed characterization of patients with preoperative moderate MR undergoing TAVI is necessary to identify those with a disease progression risk.https://www.mdpi.com/1648-9144/61/4/686TAVItranscatheter aortic valve interventionmitral regurgitation |
| spellingShingle | Massimo Baudo Serge Sicouri Francesco Cabrucci Yoshiyuki Yamashita Dimitrios E. Magouliotis Sarah M. Carnila Sandra V. Abramson Katie M. Hawthorne Harish Jarrett Roberto Rodriguez Scott M. Goldman Paul M. Coady Eric M. Gnall William A. Gray Sandro Gelsomino Basel Ramlawi Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation Medicina TAVI transcatheter aortic valve intervention mitral regurgitation |
| title | Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation |
| title_full | Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation |
| title_fullStr | Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation |
| title_full_unstemmed | Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation |
| title_short | Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation |
| title_sort | evolution of untreated moderate mitral regurgitation after transcatheter aortic valve implantation |
| topic | TAVI transcatheter aortic valve intervention mitral regurgitation |
| url | https://www.mdpi.com/1648-9144/61/4/686 |
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