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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
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Mitral regurgitation after transcatheter aortic valve replacement
Francesco Nappi1, Antonio Nenna2, Irina Timofeeva3
1Department of Cardiac Surgery, Centre Cardiologique du Nord de Saint-Denis, Paris, France.
Journal of Thoracic Disease
|July 10, 2020
Summary
Transcatheter aortic valve replacement (TAVR) patients with mitral regurgitation (MR) face risks of left ventricular failure. Understanding MR
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Transcatheter aortic valve replacement (TAVR) is increasingly used for aortic stenosis.
- Significant mitral regurgitation (MR) is a common comorbidity in TAVR patients.
- The impact of MR on TAVR outcomes is not fully understood due to trial exclusions.
Purpose of the Study:
- To explore the anatomical, functional, and clinical implications of MR in TAVR patients.
- To highlight the importance of addressing MR for optimal TAVR outcomes.
- To inform future strategies and clinical trial designs.
Main Methods:
- Review of existing evidence from randomized studies and registries.
- Analysis of factors influencing MR severity in the TAVR context.
- Consideration of pre- and post-procedural MR effects.
Main Results:
- The prevalence of moderate-to-severe MR in TAVR patients ranges from 2% to 33%.
- Preoperative or postprocedural MR can negatively impact short- and long-term outcomes, including cardiac mortality.
- Patients with moderate-to-severe MR may experience hemodynamic instability during TAVR.
Conclusions:
- Concomitant MR in TAVR patients requires careful attention due to its prognostic significance.
- Adverse LV remodeling can be triggered by MR, impacting outcomes.
- Further evaluation in clinical trials is needed to guide adjunctive treatment strategies for MR in TAVR.
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