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

• Published in: Postępy w kardiologii interwencyjnej 2019-01, Vol.15 (2), p.187-194
• Main Authors: Abdullah, Obai, Omran, Jad, Al-Dadah, Ashraf, Enezate, Tariq
• Format: Article
• Language: English
• Subjects: Catheters; mitral regurgitation; Mortality; Original Paper; outcomes; Prostheses; Stroke; transcatheter aortic valve replacement
• ISSN: 1734-9338; 1897-4295
• DOI: 10.5114/aic.2019.86011

Transcatheter aortic valve replacement (TAVR) is currently considered a class I indication for patients with severe symptomatic aortic stenosis and high/prohibitive surgical risk. We describe the effect of concomitant mitral valve regurgitation (MR) on post-procedural TAVR outcomes. 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. 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%, = 0.03). There was no significant difference between groups in terms of all-cause mortality (4.1% vs. 4.5%, = 0.59), AMI (3.2% vs. 2.9%, = 0.59), bleeding (33.4% vs. 35.6%, = 0.19), mechanical complications of prosthetic valve (2.5% vs. 1.9%, = 0.31), VC (3.2% vs. 4.4%, = 0.06), the need for PPM (7.9% vs. 9.1%, = 0.21) or 30-day readmission rates (19.0% vs. 19.1%, = 0.95). TAVR-MR was associated with lower post-procedural stroke but comparable other in-hospital outcomes and 30-day readmission rates to TAVR-C.