0243: Changes in mitral regurgitation severity after successful aortic valve implantation: impact on the development of heart failure

Backgroundthe association of severe aortic stenosis and mitral regurgitation (MR) is not rare in patients undergoing transcatheter aortic valve implantation (TAVI). The effect of TAVI on MR and its impact on outcome was evaluated.MethodsAll patients undergoing TAVI in our center were evaluated. Patients with paravalvular leak or residual stenosis after TAVI were excluded. Ninety out of 166 patients undergoing TAVI had follow-up data on post-procedural MR and constituted the patient population. Mitral regurgitation was graded on a 0-4 scale and divided into two categories for survival analysis, minimal (none/mild MR [grade 0-1/4]) and significant MR (moderate /severe MR [grade 2-4/4]). Patients were followed for a median of 427 days for death and development of heart failure (HF).ResultsAverage age was 81±6; 49% were male and the average Euroscore was 22±15. Mitral regurgitation before TAVI was minimal in 52 pts (58%) and significant in 38 pts (42%). Post TAVI, MR was minimal in 56 pts (62%) and significant in 34 pts (38%). Sixteen pts (18%)developed worsening MR with an increase of at least one MR grade post TAVI, 25 pts (28%) has an improvement in the MR (MR grade was less) and 49 pts (54%) no change occurred in the MR. Development of significant MR post successful TAVI was a strong predictor of the development of HF (49±9% vs 70±6%, respectively, p=0.02) as well as the combined end point of death and HF (event free survival 46%±9% versus 64%±7%).ConclusionsMR post TAVI without aortic regurgitation or residual stenosis is a commmon issue and predicts the developemnt of HF and death