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Aortic Stenosis and Mitral Regurgitation: Takeaways From the Heart Valve Collaboratory Workshop on Multivalvular

Syed Zaid1, Vivian Ng2, Rebecca T Hahn2

  • 1Baylor College of Medicine, Michael DeBakey VA Medical Center, Houston, Texas, USA.

Journal of the American College of Cardiology
|June 27, 2025
PubMed

Insights

Managing multivalvular disease, especially aortic stenosis with mitral regurgitation, needs better strategies. This research highlights gaps in current treatments and proposes a future research agenda for improved patient outcomes.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Multivalvular disease management is complex, with limited evidence-based guidelines.
  • Concomitant aortic stenosis and mitral regurgitation pose significant clinical challenges.
  • Current surgical and transcatheter interventions have limitations, leading to varied clinical decisions.

Purpose of the Study:

  • To synthesize insights from the 2024 Heart Valve Collaboratory (HVC) workshop on aortic stenosis + mitral regurgitation.
  • To identify unmet needs in patient selection, intervention timing, and imaging for multivalvular disease.
  • To propose a research agenda for advancing multivalvular disease management.

Main Methods:

  • Review and synthesis of key insights from the 2024 HVC workshop.
  • Analysis of limitations in current treatment approaches for concomitant aortic stenosis and mitral regurgitation.
  • Identification of critical areas for future research, including registries, trials, and AI applications.

Main Results:

  • Significant gaps exist in evidence for managing combined aortic stenosis and mitral regurgitation.
  • Unmet needs include optimal patient selection, intervention sequencing, and predicting outcomes after transcatheter aortic valve replacement.
  • A research agenda focusing on prospective studies, comparative trials, and AI is proposed.

Conclusions:

  • Standardization and personalization of multivalvular disease management require addressing identified research priorities.
  • Future research should focus on prospective registries, randomized trials, and advanced analytics.
  • This initiative aims to improve outcomes for patients with complex heart valve conditions.

Keywords:
aortic stenosisdouble-valve interventionmitral regurgitationmitral valve repairmultivalvular diseasesurgical aortic valve replacementtranscatheter aortic valve replacementtranscatheter edge-to-edge repair

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