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Original article
Mitral and aortic regurgitation following transcatheter aortic valve replacement
  1. Piotr Szymański1,
  2. Tomasz Hryniewiecki1,
  3. Maciej Dąbrowski1,
  4. Danuta Sorysz2,
  5. Janusz Kochman3,
  6. Jan Jastrzębski1,
  7. Tomasz Kukulski4,
  8. Marian Zembala4
  1. 1National Institute of Cardiology, Warsaw, Poland
  2. 2Institute of Cardiology, Collegium Medicum, Jagiellonian University, Cracow, Poland
  3. 3Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
  4. 4Silesian Center for Heart Disease, Medical University of Silesia, Zabrze, Poland
  1. Correspondence to Piotr Szymański, Acquired Heart Disease Department, Institute of Cardiology, Alpejska 42, Warsaw 04–628, Poland; p.szymanski{at}ikard.pl

Abstract

Objective To analyse the impact of postprocedural mitral regurgitation (MR), in an interaction with aortic regurgitation (AR), on mortality following transcatheter aortic valve implantation (TAVI).

Methods To assess the interaction between MR and AR, we compared the survival rate of patients (i) without both significant MR and AR versus (ii) those with either significant MR or significant AR versus (iii) with significant MR and AR, all postprocedure. 381 participants of the Polish Transcatheter Aortic Valve Implantation Registry (166 males (43.6%) and 215 females (56.4%), age 78.8±7.4 years) were analysed. Follow-up was 94.1±96.5 days.

Results Inhospital and midterm mortality were 6.6% and 10.2%, respectively. Significant MR and AR were present in 16% and 8.1% patients, including 3.1% patients with both significant MR and AR. Patients with significant versus insignificant AR differed with respect to mortality (log rank p=0.009). This difference was not apparent in a subgroup of patients without significant MR (log rank p=0.80). In a subgroup of patients without significant AR, there were no significant differences in mortality between individuals with versus without significant MR (log rank p=0.44). Significant MR and AR had a significant impact on mortality only when associated with each other (log rank p<0.0001). At multivariate Cox regression modelling concomitant significant MR and AR were independently associated with mortality (OR 3.2, 95% CI 1.54 to 5.71, p=0.002).

Conclusions Significant MR or AR postprocedure, when isolated, had no impact on survival. Combined MR and AR had a significant impact on a patient's prognosis.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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