Club35 Poster Session Thursday 12 December: 12/12/2013, 08:30-18:00 * Location: Poster area

Purpose: The coexistence of mitral regurgitation (MR) and severe aortic stenosis is a common problem in elderly patients that limits the indication for percutaneous aortic prosthesis (TAVI). However, recent publications indicate a decrease in MR after TAVI because of the improvement of left ventricle (LV) hemodynamic conditions. The aim of our study was to investigate clinical and echocardiographic predictors of MR after TAVI. Methods: We included patients undergoing TAVI from May 2008 to November 2012. It was performed a 3D transesophageal echocardiogram during the procedure and a transthoracic echocardiogram before discharge and 12 months after implantation. We studied the etiology of MR before procedure, LV ejection fraction, chambers volume, pulmonary hypertension and tricuspid regurgitation, as well as clinical and technical variables related to the procedure. Results: 90 patients underwent TAVI successfully (Table). At the beginning, 21% of patients had MR at least grade III/IV. After TAVI, 84.4% of patients showed no change in MR degree, 12.2% improved and only 3.3% worsened. Variables related with MR worsening were rheumatic MR etiology, history of atrial fibrillation (AF) and the coexistence of significant tricuspid regurgitation (TR) in the baseline study (p <0.04, p <0.01; p <0.03, respectively). Conclusions: In patients undergoing TAVI, the rheumatic etiology of MR, the previous history of AF and significant TR coexistence were factors related to MR worsening after the procedure.<cross-ref type="tbl" refid="CHAPTERsub50815TB1"></cross-ref> <tbl id="CHAPTERsub50815TB1" loc="float"><no> </no><caption> Baseline characteristics. </caption><tblbdy top-stubs="1"><r><c cspan="1" rspan="1"></c><c cspan="1" rspan="1">N = 90</c></r><r><c cspan="1" rspan="1">Age</c><c cspan="1" rspan="1">81.9 ± 6.9</c></r><r><c cspan="1" rspan="1">Women</c><c cspan="1" rspan="1">49 (54.4%)</c></r><r><c cspan="1" rspan="1">LVEF</c><c cspan="1" rspan="1">56 % ± 11.6</c></r><r><c cspan="1" rspan="1">Previous stroke</c><c cspan="1" rspan="1">16 (18%)</c></r><r><c cspan="1" rspan="1">Previous AF</c><c cspan="1" rspan="1">36 (42.4%)</c></r><r><c cspan="1" rspan="1">Baseline creatinine serum level</c><c cspan="1" rspan="1">1.3 mg/dl ± 0.5</c></r><r><c cspan="1" rspan="1">EuroSCORE</c><c cspan="1" rspan="1">16.8 ± 9.2</c></r><r><c cspan="1" rspan="1">Transfemoral approach</c><c cspan="1" rspan="1">71 (79.8%)</c></r><r><c cspan="1" rspan="1">Transapical approach</c><c cspan="1" rspan="1">18 (20.2%)</c></r></tblbdy><tblfn> LVEF: ejection fraction of the left ventricle. AF: atrial fibrillation </tblfn></tbl>