Impact of TAVI on mitral regurgitation: a prospective echocardiographic study

Echocardiography. 2013 Mar;30(3):250-7. doi: 10.1111/echo.12050. Epub 2012 Nov 27.

Abstract

Objective: This study aims to assess changes in mitral regurgitation (MR) severity after transcatheter aortic valve implantation (TAVI).

Background: Existing data on MR after TAVI are contradictory.

Methods: Thirty-five patients with MR graded ≥ 2+ were followed after undergoing TAVI with either the Edwards Sapien or CoreValve device. Echocardiography was performed the week before and 3 months after the procedure. MR was graded on a scale of 0 to 4+, classified as organic or functional, and the effective regurgitant orifice area (EROA) and MR index were calculated.

Results: At baseline, MR was graded 4+ in 4 (11.4%) patients, 3+ in 10 (28.6%), and 2+ in 21 (60%). At follow-up, MR was graded at 3+ in 4 (11.4%) patients, 2+ in 8 (22.9%), and 1+ in 19 (54.3%); 4 (11.4%) exhibited no MR. EROA (24.4 ± 11.5 mm(2) pre-TAVI vs. 11.2 ± 10.3 mm(2) post-TAVI, P < 0.001) and MR index (1.9 ± 0.3 pre-TAVI vs. 1.3 ± 0.7 post-TAVI, P < 0.001) were reduced with TAVI, independent of the etiology. MR decreased by at least 1 grade in 28 (80%) patients, with a reduction ≥2 grades in 10 (28.6%) patients; no patient showed a worsened condition. Subgroup analyses showed that the reduction in MR was significant in patients treated with the Edwards Sapien device but not in patients treated with the CoreValve device.

Conclusions: This multiparametric echocardiographic evaluation showed that MR improved significantly after TAVI and that this result may be related to the type of valve implanted.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged, 80 and over
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnostic imaging*
  • Aortic Valve Stenosis / surgery*
  • Echocardiography / methods*
  • Female
  • Heart Valve Prosthesis Implantation*
  • Humans
  • Male
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / diagnostic imaging*
  • Mitral Valve Insufficiency / surgery*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Treatment Outcome