Transcatheter aortic valve implantation and its impact on mitral valve geometry and function. Issue 9 (11th July 2020) - Meyer, Alexander
Abstract: Background: The aim of this study was to evaluate the impact of transcatheter aortic valve implantation (TAVI) on mitral valve geometry and function. Methods: Eighty‐four patients underwent TAVI. Forty‐four (52%) patients received a balloon‐expandable valve and 40 (48%) were implanted with a self‐expandable valve. All patients underwent three‐dimensional‐volumetric transesophageal echocardiography of the mitral valve before and immediately after TAVI. A dedicated software was used for assisted semiautomatic measurement of mitral annular geometry. Results: During systole, the anterior to posterior (AP) diameter was significantly reduced after the procedure (3.4 ± 0.5 cm vs 3.2 ± 0.5 cm; P < .05). The mitral annular area (10.8 ± 2.8cm 2 vs 9.9 ± 2.6cm 2 ; P < .05) as well as the tenting area (1.6 ± 0.7 cm 2 vs 1.2 ± 0.6 cm 2 ; P < .001) measured at mid‐systole were reduced after TAVI. Diastolic measures were similar. Patients treated with balloon‐expandable valves showed a significantly larger reduction in the AP diameter compared to self‐expandable valves (−0.25 cm vs −0.11 cm; P < .05). The reduction of the annular area was higher in the balloon‐expandable group (−1.2 ± 1.59 vs −0.22 ± 1.41; P < .05). Grade of mitral regurgitation did improve or remained stable after TAVI. Conclusion: TAVI significantly impacts the mitral valve and mitral annular geometry and morphology. The choice of the prosthesis (balloon‐ vs self‐expandable) may be relevant for those changes.