Assessment of mitral regurgitation and mitral complex geometry in patients after transcatheter aortic valve implantation

Abstract

Introduction: Mitral regurgitation (MR) of varying degrees and mechanisms is a common finding in patients with aortic stenosis with different improvement after transcatheter aortic valve implantation (TAVI). Aim: To evaluate the impact of TAVI on mitral complex geometry and the degree of MR. Material and methods: A total of 31 patients (29.0% males) with severe aortic stenosis and moderate or severe MR at the baseline who underwent TAVI were included in this study. Clinical and echocardiographic characteristics were determined at baseline and at 6 and 12 months. Results: After TAVI, decrease of MR vena contracta width (p = 0.00002, p = 0.00004), aorto-mural mitral annulus diameter (p = 0.00008, p = 0.02), increase of mitral annular plane systolic excursion (p = 0.0004, p = 0.0003), left ventricular stroke volume (p = 0.0003, p = 0.0004), ejection fraction (p = 0.0004, p = 0.01) and decrease of major dimension of left ventricle in three chamber view (p = 0.05, p = 0.002) were observed in patients at both time points. Additionally, we observed a decrease of distance between the head of the papillary muscles (p = 0.003) at 6 months and a decrease of left atrium volume index (p = 0.01) and systolic pulmonary artery pressure (p = 0.01) at 12 months. Conclusions: Patients with moderate or severe MR undergoing TAVI achieved significant improvement of mitral valve complex function resulting in the reduction of MR degree.