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Moderate or Severe Functional MR and Severe AS: Is Mitral Valve Surgery Justified?
Clarence Pingpoh1, Duchelle Donfack1, Tim Berger1
1Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.
The Thoracic and Cardiovascular Surgeon
|November 22, 2021
Summary
Isolated aortic valve replacement effectively reduces mitral regurgitation (MR) in patients with severe aortic stenosis and moderate to severe functional MR, offering a viable option for this high-risk group.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Coexistence of mitral regurgitation (MR) and severe aortic valve stenosis is common.
- Combined valve replacement increases morbidity and mortality.
- Isolated aortic valve replacement (AVR) is an alternative for patients with coexisting MR.
Purpose of the Study:
- To evaluate the progression of MR after isolated AVR.
- To assess the outcomes of isolated AVR in patients with moderate to severe functional MR.
Main Methods:
- Retrospective analysis of 506 patients with severe aortic stenosis and moderate to severe functional MR.
- Patients underwent either transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR).
- Echocardiographic parameters, MR severity, and survival were analyzed over a 9-year period.
Main Results:
- A significant reduction in MR was observed in both TAVI and SAVR groups (p < 0.001).
- Median ejection fraction remained stable post-procedure (35% pre-AVR vs. 36% post-AVR).
- Five-year survival rate was 25% for both TAVI and SAVR cohorts.
Conclusions:
- Isolated AVR is an adequate treatment for patients with severe aortic stenosis and coexisting moderate to severe functional MR.
- This approach may be a suitable option for high-risk patient populations.
- The study supports isolated AVR as a strategy to manage functional MR in this context.
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