Abstract 10353: Changes in the Mitral Annulus Geometry in Patients After Transcatheter Aortic Valve Implantation
Background TAVI is a feasible alternative treatment for patients with severe aortic stenosis who are inoperable and in whom concomitant mitral regurgitation (MR) is common. Changes in MR and its relation to mitral annulus geometry after TAVI are unknown. Multidetector row computed tomography (MDCT) provides details on the geometry of the mitral valve and its relationship with the aortic root, and left ventricle (LV) anatomy.
Purpose To evaluate changes in mitral valve geometry, its relationships with the aortic root and LV after TAVI. In addition, their relationships to changes in MR severity were examined.
Methods We included 50 patients (age 81+9 years, male 50%) who underwent TAVI with balloon-expandable SAPIEN valves. MDCT was performed before and at 1-month after TAVI. Changes in three-dimensional (3D) geometry of mitral annulus (3D mitral annular area, 3D perimeter), its relationship to aortic annulus (angle between aortic and mitral annular plane, the displacement between the heads of papillary muscles) and LV anatomy (the vertical distance between LV apex and mitral annulus ) were examined. Finally, the severity of MR was assessed by transthoracic echocardiography before and at 6-months after TAVI.
Results After TAVI, MR improved by > 1 grade in 23 (46%) patients. There were no significant changes in the angles between aortic and mitral annular plane were observed in patients with and without improvement in MR grades. However, in patients with MR improvement, there was a significant decrease in 3D mitral annular area (p=0.01), and a decrease in the vertical distance between LV apex and mitral annulus (p=0.03) after procedure, whereas no significant changes in these parameters were observed in patients without MR, suggesting that MR improvement is related to favorable LV remodeling post-TAVI.
Conclusion TAVI does not affect the relationship between mitral valve and aortic annulus. Improvement in MR after TAVI was caused by LV remodeling.
- © 2011 by American Heart Association, Inc.