scholarly journals Temporary worsening of mitral regurgitation due to conduction disturbance after transcatheter aortic valve implantation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takeyuki Sajima ◽  
Taichi Onimaru ◽  
Shigehito Sawamura
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Transcatheter Aortic Valve Implantation ◽  
Tissue Injury ◽  
Transcatheter Aortic Valve ◽  
Additional Procedure ◽  
Treatment Principle ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background Mitral regurgitation after transcatheter aortic valve implantation (TAVI) can be caused by various etiologies. Case presentation An 81-year-old woman with mild mitral regurgitation and complete right bundle branch block was scheduled to undergo TAVI under general anesthesia. After the deployment of the prosthetic valve, electrocardiography depicted a wide QRS wave and bradycardia, suggestive of complete atrioventricular block. Although there was no lesion indicative of tissue injury to the valve itself, worsening of mitral regurgitation was identified on transesophageal echocardiography. The hemodynamic condition was stable, and no additional procedure was performed. Electrocardiography depicted a return to a narrow QRS wave 3 days after surgery, and the mitral regurgitation appeared comparable to the preoperative grade. We assumed that the worsening of mitral regurgitation was caused by dyssynchrony in the left ventricle due to the conduction disorder. Conclusions Mitral regurgitation after TAVI needs observation, including the determination of the etiology and treatment principle.

Mitral regurgitation prior to transcatheter aortic valve implantation influences survival but not symptoms

2016 ◽  
Vol 204 ◽  
pp. 95-100 ◽  
Author(s):  
Kirsten Boerlage-van Dijk ◽  
Esther M.A. Wiegerinck ◽  
Takuro Takama ◽  
Karel T. Koch ◽  
M. Marije Vis ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

scholarly journals P1812 The effect of pre-procedural significant mitral regurgitation upon mortality after transcatheter aortic valve implantation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Soulaidopoulos ◽  
M Drakopoulou ◽  
G Oikonomou ◽  
K Stathogiannis ◽  
P Toskas ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Transcatheter Aortic Valve Implantation ◽  
Reverse Remodeling ◽  
Cumulative Mortality ◽  
Transcatheter Aortic Valve ◽  
All Cause Mortality ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background The presence of concomitant mitral regurgitation (MR) is a common issue in patients with severe aortic stenosis and negatively affects patient outcome. Available data regarding MR reduction due to aortic gradient reduction and left ventricular reverse remodeling after transcatheter aortic valve implantation (TAVI) are contradictory. Purpose To investigate the prognostic impact of both pre- and post-procedural MR in patients undergoing TAVI. Methods Patients with severe and symptomatic aortic stenosis stenosis [effective orifice area (EOA)≤1cm2] referred for TAVI at our institution were consecutively enrolled. Prospectively collected demographic, laboratory and echocardiographic data were retrospectively analyzed. Patients were stratified into two groups according to MR severity : ≤ grade 1 were defined as non-significant and ≥ grade 2 as significant. Change in MR was determined by comparison between baseline and 30-day echocardiogram. Primary clinical endpoint was all-cause mortality, as defined by the criteria proposed by the Valve Academic Research Consortium2. Results 263 consecutive patients (136 men, mean age : 80 ± 7.5 years) were included in the analysis. Significant (grade≥2) MR was present in 65 (24,7%) patients, while 198 (75,3%) patients had mild or no ( ≤ grade 1) MR. Comparing the two groups, patients with significant MR had higher systolic pulmonary pressure (51.3 ± 14.6mmHg versus 42.8 ± 11.2mmHg, p < 0.001), lower ejection fraction (47.4 ± 10.8% versus 51.2 ± 8.2%) and were more dyspnoic (New York Heart Association class IV 18.5% vesrus 2.5%, p < 0.001). The primary clinical end point occurred in 63 (24%) patients during a follow-up period of 26.6 ± 26.8 months. Patients with significant pre-procedural MR displayed greater cumulative mortality (40% versus 18.8%, p = 0.001). Perioperative risk assessed by logistic EuroScore, NYHA class and pre-procedural MR were found to significantly associate to cumulative mortality in a univariate analysis. Performing a multivariable analysis demonstrated that preprocedural MR severity could independently predict cumulative mortality [OR 2.38, B = 0.869 (95% CI 1.2 – 4.6, p = 0.01)] (Figure). Conclusion Significant MR is not infrequent in patients undergoing TAVI and appears to independently associate with high increased all-cause mortality. Abstract P1812 Figure.

scholarly journals Rapid Fire Abstract session: new insights in TAVI334Transcatheter heart valve underexpansion patterns335Echocardiography after TAVI with directflow medical prosthesis: small leaks and high gradients336Effects of transcatheter aortic valve implantation on left ventricular and atrial function evaluated by two and three-dimensional speckle tracking at eighteen-month follow-up337Impact of tricuspid regurgitation and right ventricular dysfunction on outcome of patients undergoing trans-catheter aortic valve replacement338Significant mitral regurgitation evolution in patients with severe aortic stenosis after transcatheter aortic valve implantation (TAVI): results and prognostic implications339An impact of pre- and postprocedural mitral regurgitation on mortality following TAVI340Immediate and one-year changes in systolic echocardiographic parameters after TAVI. Are there significant differences between patients with low and normal ejection fraction?341Long term echocardiographic follow-up (5-year) in transcatheter aortic valve implantation: morpho-functional changes of the implanted aortic valve: Table.

2015 ◽  
Vol 16 (suppl 2) ◽  
pp. S43-S45 ◽  
Author(s):  
B Ren ◽  
T Sturmberger ◽  
R Ancona ◽  
SL Schwartz ◽  
D Del Val Martin ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Transcatheter Aortic Valve Implantation ◽  
Severe Aortic Stenosis ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Functional Changes ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation
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