Abstract 11447: Transcatheter Aortic Vavle Replacement: Outcome of Patients with Moderate or Severe Mitral Regurgitation
Background Mitral regurgitation (MR) is present in most patients with severe aortic stenosis. Concomitant mitral valve repair or replacement is usually performed in patients with moderate or severe MR undergoing open heart surgery. In patients undergoing transcatheter aortic valve replacement (TAVR), concomitant mitral valve repair is not readily available and thus, moderate or severe MR is left untreated. The influence of moderate or severe MR on TAVR outcomes is unknown.
Methods This study included 535 consecutive patients undergoing TAVR with a balloon expandable valve. Short- and long-term survival of patients with moderate or severe MR was evaluated and compared to patients with none or mild MR using unadjusted and risk-adjusted Cox regression models.
Results A total of 149 patients (28%) presented with concomitant moderate or severe MR and 386 (72%) had none, trivial or mild MR. Patients with moderate or severe MR were older (median age 84 vs. 82 years, p = 0.01) and exhibited a higher risk profile (median STS score 8.2 vs. 7.4 %, p = 0.01). Survival rates for patients with and without moderate or severe MR were 85.0% and 93.4% at 30 days, 72.3% and 79.2% at 1 year, and 53.4% and 51.8% at 3 years, respectively (Figure). Moderate or severe MR was an independent risk factor for mortality during the first 30 days (unadjusted HR 2.32 (95% CI 1.31, 4.11), p < 0.01, adjusted HR 2.25 (1.25, 4.05), p < 0.01), but not after 30 days (unadjusted HR 1.03 (0.57, 1.85), p = 0.92, adjusted HR 1.04 (0.57, 1.90), p = 0.90).
Conclusions Moderate or severe MR in patients undergoing TAVR is associated with a higher short-term, but not long-term, mortality.
- © 2011 by American Heart Association, Inc.