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

• Published in: Postępy w kardiologii interwencyjnej 2022-09, Vol.18 (3), p.255-260
• Main Authors: Kleczynski, Pawel, Brzychczy, Piotr, Kulbat, Aleksandra, Wegrzyn, Jan, Fijalkowski, Lukasz, Okarski, Michał, Mroz, Krystian, Dziewierz, Artur, Stapor, Maciej, Trebacz, Jaroslaw, Sorysz, Danuta, Rzeszutko, Lukasz, Bartus, Stanislaw, Legutko, Jacek
• Format: Article
• Language: English
• Subjects: aortic stenosis; balloon aortic valvuloplasty; mitral regurgitation; Original Paper
• ISSN: 1734-9338; 1897-4295
• DOI: 10.5114/aic.2022.121004

Mitral regurgitation (MR) is a frequent complication in patients with severe aortic stenosis (AS). Echocardiographic assessment of MR was performed at baseline, at 30 days and at 6 months after balloon aortic valvuloplasty (BAV). Data of 271 patients were included in our final analysis, of which 21.2% ( = 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 ( = 0.003 for LVESD, = 0002 for LVEDD) and slightly lower LV ejection fraction ( = 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) cm , and 7.2 (4.5-9.9) vs. 3.2 (2.1-6.7) cm ; %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), < 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; < 0.001) and LVEF (OR = 0.95; 95% CI: 0.87-1.01; < 0.001); MR jet area (OR = 2.2, 95% CI: 1.5-4.6; < 0.001) and the presence of primary MR (OR = 3.2, 95% CI: 1.04-5.98; < 0.001) were retained as independent predictors of significant persisting MR at 6 months. 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.