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

Abstract

Introduction: Mitral regurgitation (MR) is a frequent complication in patients with severe aortic stenosis (AS). Material and methods: Echocardiographic assessment of MR was performed at baseline, at 30 days and at 6 months after balloon aortic valvuloplasty (BAV).Results: Data of 271 patients were included in our final analysis, of which 21.2% (n = 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 (p = 0.003 for LVESD, p = 0002 for LVEDD) and slightly lower LV ejection fraction (p = 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 2 , and 7.2 (4.5-9.9) vs. 3.2 (2.1-6.7) cm 2 ; %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), p < 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; p < 0.001) and LVEF (OR = 0.95; 95% CI: 0.87-1.01; p < 0.001); MR jet area (OR = 2.2, 95% CI: 1.5-4.6; p < 0.001) and the presence of primary MR (OR = 3.2, 95% CI: 1.04-5.98; p < 0.001) were retained as independent predictors of significant persisting MR at 6 months.Conclusions: 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.

Clinical outcomes of percutaneous balloon valvuloplasty in patients with critical mitral stenosis

“…Intraoperative echocardiography plays an important role in evaluating the immediate results of the BMV MVS, with the help of which it is possible to accurately determine the area of the mitral orifice after each stage of mitral orifice expansion, the degree of opening of intercommissural adhesions, the dynamics of the transmitral gradient, the state of regurgitation on the mitral valve, which are important for early diagnosis of possible complications [13,14].…”

Rescue balloon aortic valvuloplasty in a patient with cardiogenic shock followed by transcatheter aortic valve implantation

“…Symptomatic severe AS is still a life-threatening condition. Balloon aortic valvuloplasty remains a feasible method that can be used as a bridge--to-therapy as well as a bailout strategy in critical cases and followed by definite treatment [4].…”