eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
 
3/2022
vol. 18
 
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abstract:
Original paper

Balloon aortic valvuloplasty for severe aortic stenosis may reduce mitral regurgitation in mid-term follow-up

Pawel Kleczynski
1, 2
,
Piotr Brzychczy
3
,
Aleksandra Kulbat
3
,
Jan Wegrzyn
3
,
Lukasz Fijalkowski
3
,
Michał Okarski
3
,
Krystian Mroz
3
,
Artur Dziewierz
4
,
Maciej Stapor
2
,
Jaroslaw Trebacz
2
,
Danuta Sorysz
4
,
Lukasz Rzeszutko
4
,
Stanislaw Bartus
4
,
Jacek Legutko
1, 2

1.
Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
2.
Clinical Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland
3.
Students’ Scientific Group of Modern Cardiac Therapy at the Department of Interventional Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
4.
2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland
Adv Interv Cardiol 2022; 18, 3 (69): 255–260
Online publish date: 2022/11/08
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Introduction
Mitral regurgitation (MR) is a frequent complication in patients with severe aortic stenosis (AS).

Material and methods
Echocardiographic assessment of MR was performed at baseline, at 30 days and at 6 months after balloon aortic valvuloplasty (BAV).

Results
Data of 271 patients were included in our final analysis, of which 21.2% (n = 85) had at least moderate MR at baseline (in 19 (22.3%) subjects MR was diagnosed as primary). Both groups showed similar severity of AS, but patients in the MR group had a greater left ventricle (LV) size (p = 0.003 for LVESD, p = 0002 for LVEDD) and slightly lower LV ejection fraction (p = 0.04). Mitral regurgitation parameters significantly improved both at 30 days and 6 months after BAV in the MR group (MR jet area: 7.2 (4.5–9.9) vs. 3.6 (2.3–7.2) cm2, and 7.2 (4.5–9.9) vs. 3.2 (2.1–6.7) cm2; %MR/left atrial area 34.5 (23.4–42.7) vs. 17.5 (9.3–29.5) and 34.5 (23.4–42.7) vs. 14.5 (8.3–24.5), p < 0.001 for all). In multivariate logistic regression analysis, the change at 30 days, from baseline, in the LVESD (OR = 1.87; 95% CI: 1.23–2.87; p < 0.001) and LVEF (OR = 0.95; 95% CI: 0.87–1.01; p < 0.001); MR jet area (OR = 2.2, 95% CI: 1.5–4.6; p < 0.001) and the presence of primary MR (OR = 3.2, 95% CI: 1.04–5.98; p < 0.001) were retained as independent predictors of significant persisting MR at 6 months.

Conclusions
Balloon aortic valvuloplasty may reduce MR in mid-term follow-up. Predictors of persistent MR at 6 months after BAV included an increase of LVESD and MR jet area and decrease of LVEF at 30 days.

keywords:

aortic stenosis, balloon aortic valvuloplasty, mitral regurgitation

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