Abstract 18984: Impact of Functional vs. Organic Baseline Mitral Regurgitation on Short- and Long-Term Outcomes Following Transcatheter Aortic Valve Replacement
Introduction: The impact of the specific etiology of mitral regurgitation (MR) on outcomes in the TAVR population has not been previously studied.
Hypothesis: Functional MR improves to a greater degree than organic MR after relief of the aortic gradient.
Methods: The complete TAVR population from May 2007 through May 2015, who had TTE assessments of MR at baseline, was retrospectively analyzed. The TTEs were rigorously evaluated on a de-novo basis in regard to the left-ventricular function, MR etiology, severity, and mitral valve anatomy at multiple intervals including: pre- & post-procedure, 30-days, 6-months, 1-, 2-, and 3-years follow-up. Only patients with baseline ≥moderate MR were selected for this study and further divided into two groups; functional vs. organic etiology. Longitudinal, mixed-model statistical analyses were performed to assess the differences in the degree of longitudinal changes.
Results: A total of N=70 patients (44% male, mean 82 years) with ≥moderate MR at baseline including n=30 functional vs. n=40 organic MR. There were no significant differences in the baseline, procedural or in-hospital parameters. The primary outcome of mortality were similar at 30-days (10% vs. 17.5%, p=0.498) and 1-year (26.7% vs. 22.5%, p=0.687) in the functional vs. organic groups, respectively. The secondary outcomes demonstrated significant differences in the longitudinal changes including: greater degrees of improvement in MR severity, LVEF, and NYHA class in the functional vs. the organic MR groups at up to 3-years follow-up (figure).
Conclusions: Although the etiology of significant baseline MR in patients undergoing TAVR does not have an impact on 30-days or 1-year mortality, in patients with functional MR, there are greater degrees of short- and long-term improvement of MR severity, LV positive remodeling and functional class. These findings may help strategize therapies for MR in patients with aortic and mitral disease who are undergoing TAVR.
- transcatheter aortic valve replacment
- transcatheter aortic valve implantation
- mitral regurgitation
Author Disclosures: S. Kiramijyan: None. E. Koifman: None. F.M. Asch: None. M.A. Magalhaes: None. R.O. Escarcega: None. N.C. Baker: None. R. Didier: None. S.I. Negi: None. S. Minha: None. Z.D. Jerusalem: None. W. Kang: None. M.J. Lipinski: None. R. Torguson: None. J. Gai: None. P. Okubagzi: None. Z. Wang: None. I. Ben-Dor: None. L.F. Satler: None. A.D. Pichard: None. R. Waksman: None.
- © 2015 by American Heart Association, Inc.