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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
A three-dimensional echocardiographic study on aortic-mitral coupling in transcatheter aortic valve replacement
Wendy Tsang1, Massimiliano Meineri, Rebecca T Hahn
1University of Chicago Medical Center, 5841 South Maryland Avenue, MC 5084, Chicago, IL 60637, USA.
European Heart Journal. Cardiovascular Imaging
|May 31, 2013
Summary
Severe aortic stenosis impacts mitral valve function, and this effect persists even after transcatheter aortic valve replacement (TAVR). Mitral valve structure does not recover post-TAVR, suggesting a need for further assessment.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomedical Engineering
Background:
- Normal aortic valve (AV) and mitral valve (MV) function are interdependent.
- Severe aortic stenosis (AS) may affect MV function.
- Transcatheter aortic valve replacement (TAVR) is a common treatment for severe AS.
Purpose of the Study:
- To investigate the effect of severe AS on MV function.
- To determine if MV function recovers after TAVR.
- To analyze aortic-mitral coupling in patients with severe AS undergoing TAVR.
Main Methods:
- Utilized three-dimensional (3D) echocardiography to study aortic-mitral coupling.
- Compared 27 patients with severe AS (pre- and post-TAVR) to 16 controls.
- Employed custom software for automated measurements of aortic annulus (AoA) and mitral annulus (MA) morphology, angle, and motion.
Main Results:
- Patients with AS showed reduced MA displacement, MA area, and AoA area compared to controls.
- These reductions in MA and AoA parameters persisted post-TAVR.
- A wider end-systolic AoA-MA angle was observed in AS patients, remaining wider after TAVR.
Conclusions:
- Severe AS adversely affects MV structure and function due to calcification in the aortic-mitral fibrous continuity.
- TAVR does not restore MV structure.
- Findings highlight the need for MV assessment pre- and post-TAVR and may inform future TAVR valve development.
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