Objective

Transcather Aortic Valve Implantation (TAVI) has now become an established procedure for severe symptomatic aortic stenosis in patients unsuitable for an AVR. A large proportion of these patients also have mitral regurgitation (MR). TAVI for AS should physiologically improve the degree of MR post TAVI. Mid to long-term data on the consequence of TAVI on pre-existing MR is unclear. We aim to evaluate the degree of mitral regurgitation following TAVI for aortic stenosis.

Methods

Case notes for all 257 consecutive TAVIs from April 2008 – March 2015 were assessed retrospectively. Patients were routinely followed up in the outpatients clinic and Transthoracic echocardiography (TTE) performed. MR was classified into 5 categories; < mild, mild, mild-moderate, moderate and severe, based on the final quantification. Statistical analysis was performed using categorical testing for a paired sample.

Results

Pre and post TAVI MR quantification was available for 126 patients. 55% of patients were male and 9.5% were performed urgently. Logistic EuroSCORE was 12.56±9.42. The Core valve was used in 89% of cases. 21% required ICU admission, 18% required PPM, 2.5% required CVVH and 0.8% had stroke. There was no difference in MR post TAVI at a median TTE FU of 13 months (IQR 4 – 26) p=0.42. At median clinical FU of 17 months (IQR 8–35) survival was 80%. Despite MR post TAVI, NYHA class improved post TAVI.

Conclusion

There is no significant change in the degree of MR following TAVI at 1 year and this may influence long-term functional symptomatic status. Mid-term FU shows symptomatic improvement and hence NYHA status may primarily be related to aortic stenosis rather than the degree of MR. Further long-term echocardiographic and MRI follow-up is required to evaluate this further.