TRANSCATHETER INTERVENTIONS FOR CONCOMITANT SEVERE AORTIC STENOSIS AND SEVERE MITRAL REGURGITATION

2020 ◽  
Vol 75 (11) ◽  
pp. 2941
Author(s):  
Adithya Thomas Mathews ◽  
Hamza Lodhi ◽  
Priya Bansal ◽  
Haider Al Taii ◽  
Akshay Mathews ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Severe Mitral Regurgitation ◽  
Transcatheter Interventions

scholarly journals P287 Assessment of mitral regurgitation and mitral geometry in patients after transcatheter aortic valve implantation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Sorysz ◽  
A Krawczyk-Ozog ◽  
T Tokarek ◽  
B Zawislak ◽  
M Stapor ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Left Atrium ◽  
Severe Aortic Stenosis ◽  
Mitral Annulus ◽  
Severe Mitral Regurgitation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Introduction Mitral regurgitation is often found in conjunction with aortic stenosis and the prevalence of both valvular lesions increases with age. Purpose The aim of this study was to evaluate mitral regurgitation, left ventricle and left atrium in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). Methods A total of 31 patients (29% males) with severe aortic stenosis and moderate or severe mitral regurgitation, who underwent TAVI were included in this study. Clinical and echocardiographic characteristics were performed at baseline and in 6, 12 months observation. Results After TAVI, decrease of vena contracta width of mitral regurgitation (p = 0.00002, p = 0.00004), aorto-mural mitral annulus diameter (p = 0.00008, p = 0.02), increase mitral annular plane systolic excursion (p = 0.0004, p = 0.0003), left ventricular stroke volume (p = 0.0003, p = 0.0004), ejection fraction (p = 0.0004, p = 0.01) and decrease major dimension of left ventricle in three chamber view (p = 0.05, p = 0.002) was observed in patient in both time points, respectively. Additionally, we observed decrease of distance between head of papillary muscles (p = 0.003) at 6 months and decrease of left atrium indexed volume (p = 0.01) and grade of tricuspid regurgitation (p = 0.03) at 12 months follow up. Conclusions Patients with moderate or severe mitral regurgitation after TAVI procedure achieved significant reductions of mitral regurgitation and improvement of some parameters assessing mitral annulus, left ventricle and left atrium geometry.

scholarly journals Successful resuscitation from two cardiac arrests in a female patient with critical aortic stenosis, severe mitral regurgitation and coronary artery disease

2012 ◽  
Vol 69 (8) ◽  
pp. 714-716 ◽  
Author(s):  
Dragan Mijuskovic ◽  
Dusica Stamenkovic ◽  
Sasa Borovic ◽  
Menelaos Karanikolas
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Female Patient ◽  
Severe Aortic Stenosis ◽  
Severe Mitral Regurgitation ◽  
Successful Resuscitation ◽  
Critical Aortic Stenosis ◽  
Artery Disease

Introduction. The incidence of sudden cardiac death in patients with severe symptomatic aortic stenosis is up to 34% and resuscitation is described as highly unsuccessful. Case report. A 72-year-old female patient with severe aortic stenosis combined with severe mitral regurgitation and three-vessel coronary artery disease was successfully resuscitated following two in-hospital cardiac arrests. The first cardiac arrest occurred immediately after intraarterial injection of low osmolar iodinated agent during coronary angiography. Angiography revealed 90% occlusion of the proximal left main coronary artery and circumflex branch. The second arrest followed induction of anesthesia. Following successful open-chest resuscitation, aortic valve replacement, mitral valvuloplasty and three-vessel aortocoronary bypass were performed. Postoperative pericardial tamponade required surgical revision. The patient recovered completely. Conclusion. Decision to start resuscitation may be justified in selected patients with critical aortic stenosis, even though cardiopulmonary resuscitation in such cases is generally considered futile.

scholarly journals Prognosis of persistent mitral regurgitation in patients undergoing transcatheter aortic valve replacement

2020 ◽  
Vol 109 (10) ◽  
pp. 1261-1270 ◽  
Author(s):  
Victor Mauri ◽  
Maria I. Körber ◽  
Elmar Kuhn ◽  
Tobias Schmidt ◽  
Christian Frerker ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Transcatheter Aortic Valve ◽  
The Impact

Abstract Objective The objective of this study was to assess imaging predictors of mitral regurgitation (MR) improvement and to evaluate the impact of MR regression on long-term outcome in patients undergoing transcatheter aortic valve replacement (TAVR). Background Concomitant MR is a frequent finding in patients with severe aortic stenosis but usually left untreated at the time of TAVR. Methods Mitral regurgitation was graded by transthoracic echocardiography before and after TAVR in 677 consecutive patients with severe aortic stenosis. 2-year mortality was related to the degree of baseline and discharge MR. Morphological echo analysis was performed to determine predictors of MR improvement. Results 15.2% of patients presented with baseline MR ≥ 3 +, which was associated with a significantly decreased 2-year survival (57.7% vs. 74.4%, P < 0.001). MR improved in 50% of patients following TAVR, with 44% regressing to MR ≤ 2 +. MR improvement to ≤ 2 + was associated with significantly better survival compared to patients with persistent MR ≥ 3 +. Baseline parameters including non-severe baseline MR, the extent of mitral annular calcification and large annular dimension (≥ 32 mm) predicted the likelihood of an improvement to MR ≤ 2 +. A score based on these parameters selected groups with differing probability of MR ≤ 2 + post TAVR ranging from 10.5 to 94.4% (AUC 0.816; P < 0.001), and was predictive for 2-year mortality. Conclusion Unresolved severe MR is a critical determinant of long term mortality following TAVR. Persistence of severe MR following TAVR can be predicted using selected parameters derived from TTE-imaging. These data call for close follow up and additional mitral valve treatment in this subgroup. Graphic abstract Factors associated with MR persistence or regression after TAVR

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