Related Experiment Video
Updated: Jan 31, 2026
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
11.9K
Transcatheter aortic valve replacement in patients with concomitant mitral stenosis
Masahiko Asami1, Stephan Windecker1, Fabien Praz1
1Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern, Switzerland.
European Heart Journal
|January 1, 2019
Summary
Transcatheter aortic valve replacement (TAVR) patients with mitral stenosis (MS) face a significantly higher risk of cardiovascular death and stroke. This increased risk, particularly evident in rheumatic MS cases, emerges early post-procedure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Valvular Heart Disease
Background:
- Multivalvular disease is a growing concern in elderly patients undergoing transcatheter aortic valve replacement (TAVR).
- Concomitant mitral stenosis (MS) is frequently observed in patients with severe aortic stenosis (AS) undergoing TAVR.
Purpose of the Study:
- To investigate the impact of concomitant mitral stenosis (MS) on clinical outcomes in patients undergoing TAVR for severe, symptomatic aortic stenosis (AS).
Main Methods:
- Analysis of 971 patients undergoing TAVR with available echocardiographic data for MS assessment.
- Stratification of patients based on the degree and etiology of concomitant MS (degenerative vs. rheumatic).
- Comparison of clinical outcomes, including cardiovascular death and disabling stroke, between patients with and without MS at 1-year follow-up.
Main Results:
- Mitral stenosis (MS) was documented in 18.1% of TAVR patients, with moderate/severe MS in 2.9%.
- Patients with MS had a significantly increased risk of 1-year cardiovascular death (adjusted hazard ratio [HRadj] 3.64) and disabling stroke (HRadj 2.98) compared to those without MS.
- These adverse events emerged within 30 days and were predominantly driven by patients with rheumatic MS.
Conclusions:
- Concomitant MS affects approximately one-fifth of patients undergoing TAVR for severe AS.
- MS is associated with a threefold increased risk of adverse cardiovascular events at 1 year post-TAVR.
- The increased risk is early-onset and largely attributable to rheumatic MS.
Keywords:
Aortic stenosisClinical outcomesEchocardiographyMitral stenosisTranscatheter aortic valve replacementMore Related Videos
Related Concept Videos
01:22Mitral Stenosis I: Introduction
610
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
610
01:27Mitral Valve Prolapse I: Introduction
520
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
520
01:26Mitral Stenosis III: Medical Management
294
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
294
01:27Mitral Stenosis IV: Nursing Management
284
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
284
01:22Mitral Valve Prolapse II: Assessment and Management
574
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
574
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
262
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
262