Significant mitral regurgitation left untreated at the time of aortic valve replacement: a comprehensive review of a frequent entity in the transcatheter aortic valve replacement era

J Am Coll Cardiol. 2014 Jun 24;63(24):2643-58. doi: 10.1016/j.jacc.2014.02.573. Epub 2014 Mar 26.

Abstract

Significant mitral regurgitation (MR) is frequent in patients with severe aortic stenosis (AS). In these cases, concomitant mitral valve repair or replacement is usually performed at the time of surgical aortic valve replacement (SAVR). Transcatheter aortic valve replacement (TAVR) has recently been considered as an alternative for patients at high or prohibitive surgical risk. However, concomitant significant MR in this setting is typically left untreated. Moderate to severe MR after aortic valve replacement is therefore a relevant entity in the TAVR era. The purpose of this review is to present the current knowledge on the clinical impact and post-procedural evolution of concomitant significant MR in patients with severe AS who have undergone aortic valve replacement (SAVR and TAVR). This information could contribute to improving both the clinical decision-making process in and management of this challenging group of patients.

Keywords: aortic stenosis; mitral regurgitation; percutaneous therapy; transcatheter aortic valve implantation.

Publication types

  • Review

MeSH terms

  • Animals
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / surgery*
  • Cardiac Catheterization* / methods
  • Cardiac Catheterization* / trends
  • Heart Valve Prosthesis Implantation* / methods
  • Heart Valve Prosthesis Implantation* / trends
  • Humans
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / surgery*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography