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Related Experiment Videos

Does functional mitral regurgitation improve with isolated aortic valve replacement?

Nader Moazami1, Michael D Diodato, Marc R Moon

  • 1Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. Moazamin@msnotes.wustl.edu

Journal of Cardiac Surgery
|September 24, 2004
PubMed
Summary

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Isolated aortic valve replacement (AVR) may not fully resolve mitral regurgitation (MR). Patients with severe MR (3-4+) undergoing AVR have lower survival rates, suggesting repair is beneficial.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Valvular Heart Disease

Background:

  • The management of mitral regurgitation (MR) during aortic valve replacement (AVR) is debated.
  • Isolated AVR may impact the severity of concomitant functional MR.

Purpose of the Study:

  • To assess MR severity changes after isolated AVR.
  • To evaluate the survival benefit associated with isolated AVR in patients with MR.

Main Methods:

  • Retrospective analysis of 250 patients undergoing isolated AVR between 1991-2001.
  • 107 patients had follow-up transthoracic echocardiography (TTE) with a median of 818 days.
  • Preoperative MR severity was graded (1+ to 4+).

Main Results:

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  • MR improved by 1-2 grades in 45% of patients.
  • Patients with preoperative 3-4+ MR had significantly lower 3-year survival (78%) compared to those with 1-2+ MR (98%).
  • 38% of patients with 3+ MR and 71% with 4+ MR showed improvement, but some still had moderate-to-severe MR post-operatively.

    • Conclusions:

    • Isolated AVR does not consistently resolve functional MR.
    • Preoperative moderate-to-severe MR (3-4+) is associated with reduced survival after isolated AVR.
    • Repair of moderate-to-severe MR during AVR is recommended.