Impact of transcatheter aortic valve replacement on hemodynamic status in patients with aortic stenosis and mitral stenosis: Doppler echocardiographic study
| Autor: | Kenzo Hirao, Nami Omori, Nahoko Kato, Mizuho Hoshina, Hiroyuki Watanabe, Kotaro Obunai, Yu Makihara, Hiroshi Okumura, Patricia A. Pellikka, Minoru Tabata, Kentaro Shibayama |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Hemodynamics 030204 cardiovascular system & hematology Doppler echocardiography Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Valve replacement Internal medicine medicine Humans Mitral Valve Stenosis In patient Postoperative Period cardiovascular diseases 030212 general & internal medicine Aged Aged 80 and over medicine.diagnostic_test business.industry Calcinosis Stroke Volume Aortic Valve Stenosis Stroke volume medicine.disease Echocardiography Doppler Stenosis Treatment Outcome Aortic Valve Concomitant cardiovascular system Cardiology Mitral Valve Female Cardiology and Cardiovascular Medicine business Calcification |
| Zdroj: | Journal of Cardiology. 74:532-538 |
| ISSN: | 0914-5087 |
| Popis: | Background Mitral stenosis (MS) is often concomitant with aortic stenosis (AS). However, little is known about the functional status following transcatheter aortic valve replacement (TAVR) alone in patients with severe AS and MS and the impact of TAVR for AS on MS hemodynamics. Methods We enrolled 11 patients (age 83.6 ± 4.7 years, eight women) with severe AS and MS who underwent TAVR. We compared New York Heart Association (NYHA) functional class and mean transmitral pressure gradient (MPG), mitral valve area (MVA), and stroke volume (SV) measured by transthoracic Doppler echocardiography between baseline and after TAVR. We also examined the calcification of the mitral annulus and mitral leaflet opening. Results NYHA functional class improved after TAVR in all 11 patients. As SV increased after TAVR (52 ± 12 mL to 63 ± 18 mL, p = 0.041), MPG decreased and MVA increased (6.9 ± 3.8 mmHg to 5.1 ± 2.5 mmHg, p = 0.011 for MPG and 1.12 ± 0.25 cm2 to 1.49 ± 0.43 cm2, p = 0.035 for MVA). However, MPG increased in one patient in whom calcification extended into the entire anterior mitral leaflet (AML) and AML mobility was severely reduced. Conclusions NYHA functional class and hemodynamic status of MS improved after TAVR in patients with severe AS and MS. TAVR might provide therapeutic efficacy for selected symptomatic severe AS patients with MS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect