Introduction: Trans-catheter aortic valve implantation (TAVI) has become an acceptable mode of treatment for high surgical risk patients with aortic stenosis (AS) requiring valve replacement. A significant number of patients have concomitant mitral regurgitation (MR) which cannot be addressed by TAVI alone, and thus may not be suitable candidates for this procedure. We examined our results in patients undergoing TAVI and compared outcomes between those with to those without MR.
Patients: Between 2008 and 2013, 164 patients age 81+8 years underwent TAVI in our institution. Of these 87 (53%) had MR of moderate or greater degree. The groups were similar with respect to age, gender, presence of CHF, left ventricular function and co-morbid conditions. Logistic EuroSCORE was higher in the MR group (p=0.02).
Results: Procedural mortality was in 19 (12%) and similar between groups. By Kaplan-Meier estimates, overall survival at 3 years was 68% and 76% for the MR and non-MR groups respectively (p=0.6). By Cox regression age (p=0.007) and peripheral vascular disease (p=0.03) were the only predictors of late survival. Neither the presence of MR nor residual MR emerged as predictors of late mortality.
Conclusions: In elderly patients undergoing TAVI the presence of MR does not impact mid-term survival. TAVI should not be withheld from this group of patients because of concomitant MR.
