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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Changes in mitral regurgitation after balloon aortic valvuloplasty
Gabriel Maluenda1, Itsik Ben-Dor, Ana Laynez-Carnicero
1Washington Hospital Center, Washington, District of Columbia, USA.
The American Journal of Cardiology
|September 20, 2011
Summary
Nearly half of patients with severe aortic stenosis and mitral regurgitation improved after balloon aortic valvuloplasty. Smaller left atrial size and lower gradients predicted MR improvement, while larger dimensions and higher gradients predicted lack of improvement.
Area of Science:
- Cardiology
- Interventional Cardiology
- Echocardiography
Background:
- Coexisting mitral regurgitation (MR) in severe aortic stenosis (AS) is common and linked to poor outcomes.
- Balloon aortic valvuloplasty (BAV) is a treatment option for severe AS, particularly in high-risk patients.
Purpose of the Study:
- To assess changes in MR severity following BAV in patients with severe AS.
- To identify predictors of MR improvement after BAV in this population.
Main Methods:
- Retrospective analysis of 74 patients with severe AS and moderate-to-severe MR undergoing their first BAV.
- Transthoracic echocardiography used to evaluate MR severity before and after BAV.
- Logistic regression analysis to identify correlates of MR improvement.
Main Results:
- 46% of patients experienced improved MR after BAV.
- Baseline predictors of MR improvement included smaller left atrial dimensions and lower peak aortic velocities/transaortic valve gradients.
- Logistic regression identified smaller left atrial dimension, smaller left ventricular end-diastolic dimension, and lower mean transaortic valve gradient as significant correlates of MR improvement.
Conclusions:
- Almost half of patients with severe AS and moderate-to-severe MR show MR improvement post-BAV.
- Pre-procedural left atrial and left ventricular dimensions, along with transaortic valve gradients, are associated with the likelihood of MR improvement after BAV.
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