PMID- 23063197
OWN - NLM
STAT- MEDLINE
DCOM- 20130226
LR  - 20131111
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 95
IP  - 1
DP  - 2013 Jan
TI  - Transcatheter aortic valve implantation in patients with concomitant mitral and 
      tricuspid regurgitation.
PG  - 77-84
LID - S0003-4975(12)01829-2 [pii]
LID - 10.1016/j.athoracsur.2012.08.030 [doi]
AB  - BACKGROUND: The impact of atrioventricular valve regurgitation in patients who 
      undergo transcatheter aortic valve implantation (TAVI) is not known. We examined 
      the clinical outcome after TAVI in patients with moderate or more severe 
      concomitant mitral or tricuspid regurgitation (TR). METHODS: Two hundred 
      sixty-eight consecutive patients who underwent TAVI at our institution since July 
      2007 were enrolled in this study. Patients had preoperative echocardiographic 
      assessment of aortic stenosis and concomitant valve disease. At 6 months and 1 
      year, survival, New York Heart Association (NYHA) functional status, 
      self-assessed state of health, and severity of mitral regurgitation (MR) and 
      tricuspid regurgitation (TR) were assessed. RESULTS: Preoperatively, 22.4% of 
      patients (60/268) had moderate or more severe MR, 20.1% (54/268) had moderate or 
      more severe TR, and 9.3% (25/268) had moderate or more severe MR and TR. With 
      moderate or more severe TR, 1 year all-cause mortality was significantly higher 
      compared with that of mild or less severe TR (33.9% and 20.9%, respectively; log 
      rank p = 0.028). With moderate or more severe MR, 1-year all-cause mortality was 
      30.2% compared with 21.2% in mild or less severe MR (log rank p = 0.068). Neither 
      moderate or more severe MR nor TR emerged as an independent risk factor. At 6 
      months, heart failure symptoms were significantly reduced regardless of the 
      extent of atrioventricular valve regurgitation. Sixty-seven percent of patients 
      with moderate or more severe MR and 50% of patients with moderate or more severe 
      TR had an improvement of valve regurgitation. CONCLUSIONS: Atrioventricular valve 
      regurgitation is present in a subgroup of patients undergoing TAVI whose survival 
      is impaired. The majority of surviving patients exhibit the clinical benefits of 
      TAVI with amelioration of heart failure symptoms and a decrease in severity of 
      atrioventricular valve regurgitation. At present, moderate or more severe 
      atrioventricular valve regurgitation cannot be considered a contraindication for 
      TAVI.
CI  - Copyright (c) 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Hutter, Andrea
AU  - Hutter A
AD  - Clinic for Cardiovascular Surgery, German Heart Center, Munich, Germany. 
      andrea.hutter@gmx.de
FAU - Bleiziffer, Sabine
AU  - Bleiziffer S
FAU - Richter, Valerie
AU  - Richter V
FAU - Opitz, Anke
AU  - Opitz A
FAU - Hettich, Ina
AU  - Hettich I
FAU - Mazzitelli, Domenico
AU  - Mazzitelli D
FAU - Ruge, Hendrik
AU  - Ruge H
FAU - Lange, Ruediger
AU  - Lange R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20121011
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2013 Oct;96(4):1531. PMID: 24088492
CIN - Ann Thorac Surg. 2013 Oct;96(4):1531. PMID: 24088493
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/*surgery
MH  - Aortic Valve Stenosis/complications/diagnosis/*surgery
MH  - *Cardiac Catheterization
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Humans
MH  - Male
MH  - Mitral Valve Insufficiency/*complications/diagnosis/surgery
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Tricuspid Valve Insufficiency/*complications/surgery
EDAT- 2012/10/16 06:00
MHDA- 2013/02/27 06:00
CRDT- 2012/10/16 06:00
PHST- 2012/02/11 00:00 [received]
PHST- 2012/07/31 00:00 [revised]
PHST- 2012/08/02 00:00 [accepted]
PHST- 2012/10/16 06:00 [entrez]
PHST- 2012/10/16 06:00 [pubmed]
PHST- 2013/02/27 06:00 [medline]
AID - S0003-4975(12)01829-2 [pii]
AID - 10.1016/j.athoracsur.2012.08.030 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2013 Jan;95(1):77-84. doi: 10.1016/j.athoracsur.2012.08.030. 
      Epub 2012 Oct 11.