PMID- 37889213 OWN - NLM STAT- MEDLINE DCOM- 20231030 LR - 20231030 IS - 1678-9741 (Electronic) IS - 0102-7638 (Print) IS - 0102-7638 (Linking) VI - 39 IP - 1 DP - 2023 Oct 27 TI - Prognostic Impact of Residual Moderate Mitral Regurgitation Following Valve-in-Valve Transcatheter Aortic Valve Implantation. PG - e20230012 LID - 10.21470/1678-9741-2023-0012 [doi] LID - e20230012 AB - INTRODUCTION: The impact of mitral regurgitation (MR) on valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) in patients with failed bioprostheses remains unclear. The purpose of this study was to assess the prognostic impact of residual moderate MR following VIV-TAVI. METHODS: We retrospectively analyzed 127 patients who underwent VIV-TAVI between March 2010 and November 2021. At least moderate MR was observed in 51.2% of patients before the procedure, and MR improved in 42.1% of all patients. Patients with postoperative severe MR, previous mitral valve intervention, and patients who died before postoperative echocardiography were excluded from further analyses. The remaining 114 subjects were divided into two groups according to the degree of postprocedural MR: none-mild MR (73.7%) or moderate MR (26.3%). Propensity score matching yielded 23 pairs for final comparison. RESULTS: No significant differences were found between groups before and after matching in early results. In the matched cohort, survival probabilities at one, three, and five years were 95.7% vs. 87.0%, 85.0% vs. 64.5%, and 85.0% vs. 29.0% in the none-mild MR group vs. moderate MR-group, respectively (log-rank P=0.035). Among survivors, patients with moderate MR had worse functional status according to New York Heart Association (NYHA) class at follow-up (P=0.006). CONCLUSION: MR is common in patients with failed aortic bioprostheses, and improvement in MR-status was observed in over 40% of patients following VIV-TAVI. Residual moderate MR after VIV-TAVI is not associated with worse early outcomes, however, it was associated with increased mortality at five years of follow-up and worse NYHA class among survivors. FAU - Stankowski, Tomasz AU - Stankowski T AUID- ORCID: 0000-0003-2054-8199 AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Aboul-Hassan, Sleiman Sebastian AU - Aboul-Hassan SS AD - Department of Cardiac Surgery, Medinet Heart Center Ltd., Nowa Sol, Poland. AD - Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, Zielona Gora, Poland. FAU - Salem, Mohammed AU - Salem M AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Rochor, Kristin AU - Rochor K AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Schenk, Soeren AU - Schenk S AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Erkenov, Temirlan AU - Erkenov T AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Zinab, Farzaneh Seifi AU - Zinab FS AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Muehle, Anja AU - Muehle A AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Herwig, Volker AU - Herwig V AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Harnath, Axel AU - Harnath A AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Sa, Michel Pompeu AU - Sa MP AD - Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, United States of America. AD - Department of Cardiothoracic Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, United States of America. FAU - Ramlawi, Basel AU - Ramlawi B AD - Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, United States of America. AD - Department of Cardiothoracic Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, United States of America. FAU - Fritzsche, Dirk AU - Fritzsche D AD - Department of Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany. FAU - Perek, Bartlomiej AU - Perek B AD - Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland. LA - eng PT - Journal Article DEP - 20231027 PL - Brazil TA - Braz J Cardiovasc Surg JT - Brazilian journal of cardiovascular surgery JID - 101677045 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Prognosis MH - Retrospective Studies MH - Treatment Outcome MH - *Mitral Valve Insufficiency/diagnostic imaging/etiology/surgery MH - *Aortic Valve Stenosis/surgery MH - Aortic Valve/surgery MH - *Heart Valve Prosthesis Implantation/adverse effects/methods MH - *Heart Valve Prosthesis/adverse effects PMC - PMC10610905 OTO - NOTNLM OT - Bioprosthesis OT - Follow-Up Studies OT - Mitral Valve OT - Mitral Valve Insufficiency OT - Prognosis OT - Propensity Score OT - Retrospective Studies OT - Survivors COIS- Conflict of interest: Volker Herwig is consultant for Medtronic; Axel Harnath is consultant for Medtronic; Basel Ramlawi has received financial support from Medtronic, Corcym, and AtriCure; and Sleiman Sebastian Aboul-Hassan has received financial support from Getinge. EDAT- 2023/10/27 12:43 MHDA- 2023/10/30 06:47 PMCR- 2023/10/23 CRDT- 2023/10/27 10:32 PHST- 2023/10/30 06:47 [medline] PHST- 2023/10/27 12:43 [pubmed] PHST- 2023/10/27 10:32 [entrez] PHST- 2023/10/23 00:00 [pmc-release] AID - 10.21470/1678-9741-2023-0012 [doi] PST - epublish SO - Braz J Cardiovasc Surg. 2023 Oct 27;39(1):e20230012. doi: 10.21470/1678-9741-2023-0012.