Mitral regurgitation after transcatheter aortic valve replacement
| Autor: | Irina Timofeeva, Massimo Chello, Antonio Nenna, Francesco Nappi, Federico Gentile, Christos G. Mihos |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Mitral regurgitation business.industry medicine.medical_treatment Hemodynamics 030204 cardiovascular system & hematology medicine.disease law.invention Clinical trial 03 medical and health sciences Stenosis 0302 clinical medicine medicine.anatomical_structure Randomized controlled trial Valve replacement law Internal medicine Concomitant Mitral valve Cardiology Medicine 030212 general & internal medicine Review Article on Novel Concepts in Cardiopulmonary and Structural Heart Disease business |
| Zdroj: | J Thorac Dis |
| ISSN: | 2077-6624 2072-1439 |
| DOI: | 10.21037/jtd.2020.01.69 |
| Popis: | Patients undergoing transcatheter aortic valve replacement (TAVR) might have an associated significant MR that can potentially lead to left ventricular (LV) failure after procedure. Considering the specific alterations in the mitral valve in TAVR scenario and the widespread use of TAVR in recent years, it appears important to know and understand the anatomical, functional and clinical implications to develop adequate strategies for the future. Patients with severe mitral regurgitation (MR) have been generally excluded from randomized clinical trials, making poor the impact that associated MR can have on clinical outcomes after TAVR. Several factors must be considered whose presence influences the severity of MR. For example, the elevated prevalence of coronary disease with consequent ischemic MR may account for LV dilation observed at the end stage of aortic stenosis. Evidence randomized studies and registries suggests that the rate of concomitant moderate-to-severe MR in patients undergoing TAVR oscillates between 2% and 33%, and patients with moderate to severe MR may have hemodynamic frailty with clinical deterioration during mechanical intervention. Short- and long-term outcomes, including cardiac mortality, appear to be influenced by the existence of preoperative moderate-to-severe MR or by the postprocedural worsening of mild MR, generally due to adverse LV remodeling. The incidence and the prognostic effect of concomitant MR in patients undergoing TAVR requires specific attention as might trigger adjunctive strategy treatment which should be carefully evaluated in clinical trials. Keywords Mitral regurgitation (MR); mitral valve; transcatheter aortic valve; transcatheter aortic valve replacement (TAVR). |
| Databáze: | OpenAIRE |
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