Risk factors for residual mitral regurgitation after aortic valve replacement in patients with severe aortic valve stenosis and moderate mitral regurgitation.

Gen Thorac Cardiovasc Surg

Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-Ku, Sapporo, 060-8638, Japan.

Published: October 2019

AI Article Synopsis

  • The study aimed to identify risk factors for residual moderate mitral regurgitation (MR) after surgical aortic valve replacement (SAVR).
  • Among 222 patients who underwent SAVR, 33 had functional moderate MR pre-surgery; those with residual MR post-surgery were compared to those whose MR improved.
  • Key findings showed that a larger left atrial diameter and a smaller mean aortic valve pressure gradient were associated with residual MR, with a specific ratio predicting this condition effectively.

Article Abstract

Objectives: While it was reported that patients with residual moderate mitral regurgitation (MR) after surgical aortic valve replacement (SAVR) had a poorer prognosis than those without it, the risk factors for residual MR have not been fully elucidated. The aim of the study was to evaluate risk factors for residual MR after SAVR.

Methods: Of the 222 patients who underwent isolated SAVR from 2001 to 2018, 33 (11 men; age: 74 ± 7 years) had functional moderate MR before surgery. The risk factors for residual MR were evaluated by comparing patients with residual moderate MR (n = 11, 33%) with those who exhibited improved post-surgery MR (n = 22, 67%).

Results: The left atrial diameter was significantly larger in the residual MR group (51 ± 7 mm) than in the improved MR group (46 ± 5 mm; P = 0.049). The mean pressure gradient at the aortic valve was significantly smaller in the residual MR group (52 ± 18 mmHg) than in the improved MR group (69 ± 22 mmHg; P = 0.043). A ratio of left atrial diameter (mm) and mean aortic valve pressure gradient (mmHg) greater than 0.9 predicted residual MR with a sensitivity of 70% and a specificity of 74% (area under the ROC curve: 0.779; P = 0.015).

Conclusions: In patients with severe aortic valve stenosis and moderate MR, a high ratio of preoperative left atrial diameter and mean aortic valve pressure gradient would be a parameter predicting residual moderate MR post-SAVR.

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http://dx.doi.org/10.1007/s11748-019-01110-wDOI Listing

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