For a study, researchers sought to evaluate clinical and echocardiographic outcomes following TAVI in patients with pre-procedural Mitral regurgitation (MR). A retrospective chart review was performed from March 2018 through June 2020, during which all transcatheter aortic valve implantation (TAVI) patients were identified. Patients were classified as having mild, moderate, or severe MR based on the transthoracic echocardiogram (TTE) performed before TAVI. Patients who underwent TAVI but were discharged from the hospital without a 6-month follow-up were not eligible for the study. At 6 months, clinical outcomes comprised all-cause mortality, severe adverse cardiovascular events, clinically significant bleeding, changes in ejection fraction (EF) category, and MR severity changes. About 33% of the 118 included patients (age 76±10 years, 79% male, 46% White) had MR, with 26% having mild MR and 7% having significant MR. Before TAVI, AS+MR patients were more likely to have a reduced EF (<50%) by category than those with AS alone (33.3% vs. 8.8%, P=0.01), but after TAVI, they were more likely to exhibit an increase in EF by category (19.4% vs. 5.5%, P=0.039). In terms of all-cause mortality (12.8 vs. 5.1%, P=0.14), major adverse cardiovascular events (17.9 vs. 8.9%, P=0.15), and clinically significant bleeding (10.3 vs. 6.3%, P=0.45), no significant differences were identified between the two groups. At 6 months, the clinical outcomes of patients who had AS and co-existing MR after TAVI were equivalent to those of individuals who had AS alone. However, they were likelier to exhibit elevations in the EF category 6 months after the valve implantation. The outcomes supported the conclusion that TAVI could improve left ventricular function in patients with mild or moderate MR in addition to treating the aortic valve. These patients were candidates for the procedure.
Source – ajconline.org/article/S0002-9149(22)00527-6/fulltext
