Impact of TAVI on Mitral Regurgitation: A Prospective Echocardiographic Study.

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 mm2 pre- TAVI vs. 11.2 ± 10.3 mm2 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 Core Valve 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. [ABSTRACT FROM AUTHOR]