RT Journal Article
T1 Mitral Regurgitation After Transcatheter Aortic Valve Replacement: Prognosis, Imaging Predictors, and Potential Management.
A1 Cortés, Carlos
A1 Amat-Santos, Ignacio J
A1 Nombela-Franco, Luis
A1 Muñoz-Garcia, Antonio J
A1 Gutiérrez-Ibanes, Enrique
A1 De La Torre Hernandez, José M
A1 Córdoba-Soriano, Juan G
A1 Jimenez-Quevedo, Pilar
A1 Hernández-García, José M
A1 Gonzalez-Mansilla, Ana
A1 Ruano, Javier
A1 Jimenez-Mazuecos, Jesús
A1 Castrodeza, Javier
A1 Tobar, Javier
A1 Islas, Fabian
A1 Revilla, Ana
A1 Puri, Rishi
A1 Puerto, Ana
A1 Gómez, Itziar
A1 Rodés-Cabau, Josep
A1 San Román, José A
K1 MDCT
K1 MitraClip
K1 mitral regurgitation
K1 percutaneous valve therapies
K1 transcatheter aortic valve replacement
AB This study sought to analyze the clinical impact of the degree and improvement of mitral regurgitation in TAVR recipients, validate the main imaging determinants of this improvement, and assess the potential candidates for double valve repair with percutaneous techniques. Many patients with severe aortic stenosis present with concomitant mitral regurgitation (MR). Cardiac imaging plays a key role in identifying prognostic factors of MR persistence after transcatheter aortic valve replacement (TAVR) and for planning its treatment. A total of 1,110 patients with severe aortic stenosis from 6 centers who underwent TAVR were included. In-hospital to 6-month follow-up clinical outcomes according to the degree of baseline MR were evaluated. Off-line analysis of echocardiographic and multidetector computed tomography images was performed to determine predictors of improvement, clinical outcomes, and potential percutaneous alternatives to treat persistent MR. Compared with patients without significant pre-TAVR MR, 177 patients (16%) presented with significant pre-TAVR MR, experiencing a 3-fold increase in 6-month mortality (35.0% vs. 10.2%; p 35.5 mm (odds ratio: 9.0; 95% confidence interval: 3.2 to 25.3; p  Significant MR is not uncommon in TAVR recipients and associates with greater mortality. In more than one-half of patients, the degree of MR improves after TAVR, which can be predicted by characterizing the mitral apparatus with multidetector computed tomography. According to standardized imaging criteria, at least 1 in 10 patients whose MR persists after TAVR could benefit from percutaneous mitral procedures, and even more could be treated with MitraClip after dedicated pre-imaging evaluation.
YR 2016
FD 2016
LK http://hdl.handle.net/10668/10336
UL http://hdl.handle.net/10668/10336
LA en
DS RISalud
RD Apr 5, 2025