eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
2/2019
vol. 15
 
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abstract:
Original paper

Outcomes of transcatheter aortic valve replacement in patients with mitral valve regurgitation

Obai Abdullah
1
,
Jad Omran
2
,
Ashraf Al-Dadah
3
,
Tariq Enezate
1

1.
Division of Cardiology, University of Missouri Hospital and Clinical, Columbia, MO, USA
2.
Sulpizio Cardiovascular Center, University of California San Diego, San Diego, CA, USA
3.
Prairie Heart Institute, O’Fallon, IL, USA
Adv Interv Cardiol 2019; 15, 2 (56): 187–194
Online publish date: 2019/06/26
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Introduction
Transcatheter aortic valve replacement (TAVR) is currently considered a class I indication for patients with severe symptomatic aortic stenosis and high/prohibitive surgical risk.

Aim
We describe the effect of concomitant mitral valve regurgitation (MR) on post-procedural TAVR outcomes.

Material and methods
The study population was extracted from the 2014 National Readmissions Data (NRD) using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for TAVR, MR and post-procedural outcomes. Propensity matching was used to extract a control group of TAVR patients without MR (TAVR-C) to the TAVR with concomitant MR group (TAVR-MR). Study outcomes included in-hospital all-cause mortality, in-hospital post-procedural stroke, acute myocardial infarction (AMI), bleeding, mechanical complications of prosthetic valve, vascular complications (VC), need for new permanent pacemaker implantation (PPM) and 30-day readmission rates.

Results
A total of 1511 patients were identified in each group (mean age: 81.7 years, 49.3% male); the two groups were comparable in terms of baseline characteristics and co-morbidities. When compared to TAVR-C, TAVR-MR was associated with lower post-procedural stroke (3.5% vs. 5.2%, p = 0.03). There was no significant difference between groups in terms of all-cause mortality (4.1% vs. 4.5%, p = 0.59), AMI (3.2% vs. 2.9%, p = 0.59), bleeding (33.4% vs. 35.6%, p = 0.19), mechanical complications of prosthetic valve (2.5% vs. 1.9%, p = 0.31), VC (3.2% vs. 4.4%, p = 0.06), the need for PPM (7.9% vs. 9.1%, p = 0.21) or 30-day readmission rates (19.0% vs. 19.1%, p = 0.95).

Conclusions
TAVR-MR was associated with lower post-procedural stroke but comparable other in-hospital outcomes and 30-day readmission rates to TAVR-C.

keywords:

transcatheter aortic valve replacement, outcomes, mitral regurgitation

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