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The predictive value of a modified Carpentier classification in patients with coincidental mitral regurgitation undergoing TAVI for severe aortic valve stenosis1
- Source :
- Clinical hemorheology and microcirculation. 70(1)
- Publication Year :
- 2018
-
Abstract
- Introduction Concomitant mitral-regurgitation (MR) is frequently observed in patients undergoing trans-catheter aortic valve implantation (TAVI). The predictive value of MR etiology remains to be elucidated. Methods 600 patients with coincidental MR (≥moderate) undergoing TAVI were categorized according to a modified Carpentier classification [Groups: no/mild MR, n = 477; left atrial (LA) functional MR, n = 18; MR due to left ventricular dilatation, n = 29; degenerative MR, n = 50; MR with restricted leaflet motion n = 26]. MR improvement and patient outcome was compared among the groups in a retrospective analysis. Results MR regression was most pronounced in patients with restricted leaflet motion after 6 months, although a significant improvement was observed in all subgroups. MR relief was predominantly observed within the first 30 days after TAVI. Only patients with restricted leaflet motion experienced further improvement thereafter.In the entire cohort a total of 15 strokes (2.5%) during the first 30 days after TAVI were observed, with the highest incidence in the LA functional cohort (3 events, 17%; p = 0.008). In multivariate analysis, organic etiology was associated with an increased 1-year mortality.In conclusion, despite significant MR regression in all MR groups, some individuals may require additional mitralvalve repair after TAVI. According to our data the timing of these procedures should be based on the underlying MR etiology. The Carpentier classification in patients with coincidental MR undergoing TAVI for severe AS may also have prognostic implications as we found an increased incidence of strokes in our LA functional cohort and a worse mortality rates in organic MR.
- Subjects :
- Aortic valve
Male
medicine.medical_specialty
Physiology
2720 Hematology
610 Medicine & health
030204 cardiovascular system & hematology
2705 Cardiology and Cardiovascular Medicine
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
2737 Physiology (medical)
Physiology (medical)
Internal medicine
medicine
Humans
In patient
030212 general & internal medicine
Aged
Retrospective Studies
Aged, 80 and over
Mitral regurgitation
business.industry
Incidence (epidemiology)
Mortality rate
Mitral Valve Insufficiency
Hematology
1314 Physiology
Aortic Valve Stenosis
Prognosis
medicine.anatomical_structure
Treatment Outcome
Concomitant
Cohort
Cardiology
Etiology
10209 Clinic for Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 18758622
- Volume :
- 70
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Clinical hemorheology and microcirculation
- Accession number :
- edsair.doi.dedup.....9948c4808735bebb7cbcf11b29dbff70