Impact of concomitant mitral regurgitation during transcatheter aortic valve replacement on 1-year survival outcomes

Kaoru Matsuura, Hiraku Kumamaru, Shun Kohsaka, Tomoyoshi Kanda, Daichi Yamashita, Hideki Kitahara, Kazuo Shimamura, Yoshio Kobayashi, Goro Matsumiya

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We investigated the influence of concomitant mitral regurgitation (MR) in patients undergoing transcatheter aortic valve implantation on the 1-year outcome using Japan Transcatheter Valve Therapy (J-TVT) registry data. Methods: The patients who underwent the transcatheter aortic valve implantation for aortic stenosis performed from August 2013 to December 2019 in Japan were included. History of previous valve surgery and dialysis patients were excluded. A total of 24,979 patients were included, and 1-year follow-up data were obtained from the registry (follow-up rate 98.5 %). Propensity-score matching, using multivariable logistic regression and 1:1 matching without replacement, was performed between the patients with grade 3–4 MR (MR 3–4 group) and those with grade 0–2 MR (MR 0–2 group). All-cause death and the composite outcome of death and/or heart failure events were compared. Results: After propensity score matching, 3920 cases (1960 cases each in MR 0–2 group and MR 3–4 group) were extracted. The procedure success rate was 96.4 % in MR 0–2 and 96.0 % in MR 3–4 group (p = 0.56) and the surgical conversion rate was 0.7 % in MR 0–2 group and 0.8 % in MR 3–4 group (p = 0.58). Cox regression model showed no statistical difference in 1-year survival rate between MR 0–2 group (89.4 %) and MR 3–4 group (89.6 %) (p = 0.80). However, freedom from 1-year death and/or heart failure event was lower in MR 3–4 (86.3 %) than in MR 0–2 group (88.9 %) (p = 0.01). This trend was also found in the subgroup of New York Heart Association (NYHA) class 1–2 but not in the subgroup of NYHA class 3–4. Conclusions: One-year survival rate was not different between groups but freedom from death and/or heart failure events was lower in patients with preoperative MR grade 3–4 than in patients with preoperative MR grade 0–2 after transcatheter aortic valve replacement.

Original languageEnglish
Pages (from-to)16-21
Number of pages6
JournalJournal of Cardiology
Volume82
Issue number1
DOIs
Publication statusPublished - 2023 Jul

Keywords

  • Aortic valve replacement/implantation
  • Outcomes
  • Prognosis
  • Transcatheter

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Impact of concomitant mitral regurgitation during transcatheter aortic valve replacement on 1-year survival outcomes'. Together they form a unique fingerprint.

Cite this