{
  "abstract": "Introduction Transcatheter aortic valve implantation(TAVI) procedure is an established treatment for severe aortic stenosis(AS) in inoperable patients. In those patients mitral regurgitation(MR) is often a co-existing pathology. Although some MR improvement post-TAVI is expected, timeframe and predictors for this and how it may influence all-cause mortality remain unclear.Objectives To evaluate MR severity changes at pre-agreed time points following a successful TAVI, assess how this correlates with baseline LV function, tricuspid regurgitation(TR), valve type used and patient gender and determine the impact on all-cause mortality.Methods A registry of consecutive patients (n=924) undergoing successful TAVI at a high-volume tertiary centre between 2020 and 2024 was reviewed to identify those with pre-existing functional MR. MR severity was assessed by BSE-accredited practitioners using transthoracic echocardiography and a multimetric semi-quantitative approach, categorised as none, mild, moderate, or severe. Echocardiographic data were retrospectively analysed at baseline, immediately post-procedure, and at 3–6-month outpatient follow-up. 2-year all-cause mortality was obtained from the TAVI registry. MR improvement predictors and impact on mortality were analysed using standard comparative statistics.Results A total of 124 patients with baseline MR were included in this retrospective single-centre study. Mean age was 81.2±8.0 years, 59 were male(47.7%) and 65 female(52.4%). Self-expanding valve was used in 45%(n=56) and balloon-expandable in 55%(n=68). Baseline MR was categorised as mild in 16.3%(n=20), moderate in 67.4%(n=84) and severe in 16.3%(n=20) of patients. Immediately post procedure MR improved by at least one grade in 45.5%(n=56) of patients (p<0.01). At first outpatient review MR improvement was noted in 70%(n=87)(p<0.01) ( figure 1). Where MR severity remained static immediately post-TAVI, a delayed improvement was observed at outpatient echocardiography in 26.6%(n=33)(p<0.01). There was no significant correlation between MR improvement and valve platform used (OR 0.80, p=0.606). MR improvement was also independent of operator (p=0.711), patient gender (OR 0.75, p=0.432), baseline LV function (r=−0.147, p=0.111) or baseline TR (ρ=0.046, p=0.641). However, in female patients with moderate or severe baseline MR, a trend was observed towards greater early MR improvement (OR for male vs female 0.47,95%CI 0.21–1.03,p=0.056).Higher baseline MR severity was associated with subsequent improvement (ρ=0.295,p=0.001). Patients with both early and delayed MR improvement had lower post-procedural all-cause mortality (death OR0.37, 95%CI 0.15–0.94; p=0.036).Conclusion Our study reports a significant improvement in baseline MR severity post-TAVI both immediately and at outpatient follow-up. This was independent of valve platform, operator, patient sex, LV function or TR severity. MR improvement was associated with lower all-cause mortality.Abstract 545 Figure 1MR severity in patients undergoing TAVI",
  "authors": [
    {
      "affiliations": [
        "Royal Brompton and Harefield Hospitals, part of Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom"
      ],
      "name": "Aleksandar Dimitrov"
    },
    {
      "affiliations": [
        "Royal Brompton and Harefield Hospitals, part of Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom"
      ],
      "name": "Nareen Dezayie"
    },
    {
      "affiliations": [
        "Royal Brompton and Harefield Hospitals, part of Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom"
      ],
      "name": "Anasthasios Sakalidis"
    },
    {
      "affiliations": [
        "Royal Brompton and Harefield Hospitals, part of Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom"
      ],
      "name": "Vasileios Panoulas"
    }
  ],
  "title": "545 Patterns of mitral regurgitation after transcatheter aortic valve implantation and association with mortality",
  "uid": "eff735bd-7c98-5a80-b228-fb5a25d919a4"
}