title: Incidental moderate mitral regurgitation in patients undergoing aortic valve replacement for aortic stenosis: review of guidelines and current evidence.
abstract: Recent evidence has shown that moderate mitral regurgitation is common and clinically relevant in patients presenting for surgical and transcatheter aortic valve replacement for aortic stenosis. Prospective multicenter clinical trials are now indicated to resolve the clinical equipoise about whether or not mitral valve intervention also is indicated at the time of aortic valve intervention. Advances in three-dimensional transesophageal echocardiography, transcatheter mitral interventions, and surgical aortic valve replacement, including the advent of sutureless valves, likely will expand the therapeutic possibilities for moderate mitral regurgitation in the setting of aortic valve interventions for severe aortic stenosis.
authors: Department of Cardiac Anesthesia, Mayo Clinic, Scottsdale, AZ.
authors: Harish
authors: H
authors: Ramakrishna
authors: Department of Anesthesiology and Critical Care, Cardiovascular and Thoracic Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors: Benjamin A
authors: BA
authors: Kohl
authors: Department of Surgery, Division of Cardiovascular Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors: Arminder S
authors: AS
authors: Jassar
authors: Department of Anesthesiology and Critical Care, Cardiovascular and Thoracic Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: yiandoc@hotmail.com.
authors: John G T
authors: JG
authors: Augoustides
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D006328:Cardiac Catheterization; D017548:Echocardiography, Transesophageal; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods / Q000639:trends; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000209:etiology* / Q000503:physiopathology*; D011183:Postoperative Complications / Q000503:physiopathology*
keywords: aortic stenosis; clinical outcomes; effective orifice area; guidelines; minimally invasive aortic valve replacement; mitral valve repair; mitral valve replacement; moderate mitral regurgitation; regurgitant fraction; regurgitant volume; surgical aortic valve replacement; sutureless aortic valves; three-dimensional transesophageal echocardiography; transcatheter aortic valve replacement; transcatheter mitral valve interventions; vena contracta