Loading...
Please wait, while we are loading the content...
Similar Documents
Impact of Mitral Regurgitation on Clinical Outcomes of Patients With Low-Ejection Fraction, Low-Gradient Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation
| Content Provider | Scilit |
|---|---|
| Author | O’Sullivan, Crochan J. Stortecky, Stefan Bütikofer, Anne Heg, Dik Zanchin, Thomas Huber, Christoph Pilgrim, Thomas Praz, Fabien Buellesfeld, Lutz Khattab, Ahmed A. Blöchlinger, Stefan Carrel, Thierry Meier, Bernhard Zbinden, Stephan Wenaweser, Peter Windecker, Stephan |
| Copyright Year | 2015 |
| Description | Journal: Circulation: Cardiovascular Interventions Background—: Up to 1 in 6 patients undergoing transcatheter aortic valve implantation (TAVI) present with low-ejection fraction, low-gradient (LEF-LG) severe aortic stenosis and concomitant relevant mitral regurgitation (MR) is present in 30% to 55% of these patients. The effect of MR on clinical outcomes of LEF-LG patients undergoing TAVI is unknown. Methods and Results—: Of 606 consecutive patients undergoing TAVI, 113 (18.7%) patients with LEF-LG severe aortic stenosis (mean gradient ≤40 mm Hg, aortic valve area <1.0 cm$ ^{2}$ , left ventricular ejection fraction <50%) were analyzed. LEF-LG patients were dichotomized into ≤mild MR (n=52) and ≥moderate MR (n=61). Primary end point was all-cause mortality at 1 year. No differences in mortality were observed at 30 days ( P =0.76). At 1 year, LEF-LG patients with ≥moderate MR had an adjusted 3-fold higher rate of all-cause mortality (11.5% versus 38.1%; adjusted hazard ratio, 3.27 [95% confidence interval, 1.31–8.15]; P =0.011), as compared with LEF-LG patients with ≤mild MR. Mortality was mainly driven by cardiac death (adjusted hazard ratio, 4.62; P =0.005). As compared with LEF-LG patients with ≥moderate MR assigned to medical therapy, LEF-LG patients with ≥moderate MR undergoing TAVI had significantly lower all-cause mortality (hazard ratio, 0.38; 95% confidence interval, 0.019–0.75) at 1 year. Conclusions—: Moderate or severe MR is a strong independent predictor of late mortality in LEF-LG patients undergoing TAVI. However, LEF-LG patients assigned to medical therapy have a dismal prognosis independent of MR severity suggesting that TAVI should not be withheld from symptomatic patients with LEF-LG severe aortic stenosis even in the presence of moderate or severe MR. |
| Related Links | https://www.ahajournals.org/doi/pdf/10.1161/CIRCINTERVENTIONS.114.001895 https://core.ac.uk/download/pdf/33082798.pdf |
| Ending Page | e001895 |
| Page Count | 1 |
| Starting Page | e001895 |
| ISSN | 19417640 |
| e-ISSN | 19417632 |
| DOI | 10.1161/circinterventions.114.001895 |
| Journal | Circulation: Cardiovascular Interventions |
| Issue Number | 2 |
| Volume Number | 8 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2015-02-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Circulation: Cardiovascular Interventions Peripheral Vascular Disease Aortic Valve Stenosis Mitral Valve Insufficiency Transcatheter Aortic Valve Implantation |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine |
