title: Mitral and aortic regurgitation following transcatheter aortic valve replacement.
abstract: OBJECTIVE
  To analyse the impact of postprocedural mitral regurgitation (MR), in an interaction with aortic regurgitation (AR), on mortality following transcatheter aortic valve implantation (TAVI).
  
  
  METHODS
  To assess the interaction between MR and AR, we compared the survival rate of patients (i) without both significant MR and AR versus (ii) those with either significant MR or significant AR versus (iii) with significant MR and AR, all postprocedure. 381 participants of the Polish Transcatheter Aortic Valve Implantation Registry (166 males (43.6%) and 215 females (56.4%), age 78.8±7.4 years) were analysed. Follow-up was 94.1±96.5 days.
  
  
  RESULTS
  In-hospital and midterm mortality were 6.6% and 10.2%, respectively. Significant MR and AR were present in 16% and 8.1% patients, including 3.1% patients with both significant MR and AR. Patients with significant versus insignificant AR differed with respect to mortality (log rank p=0.009). This difference was not apparent in a subgroup of patients without significant MR (log rank p=0.80). In a subgroup of patients without significant AR, there were no significant differences in mortality between individuals with versus without significant MR (log rank p=0.44). Significant MR and AR had a significant impact on mortality only when associated with each other (log rank p<0.0001). At multivariate Cox regression modelling concomitant significant MR and AR were independently associated with mortality (OR 3.2, 95% CI 1.54 to 5.71, p=0.002).
  
  
  CONCLUSIONS
  Significant MR or AR postprocedure, when isolated, had no impact on survival. Combined MR and AR had a significant impact on a patient's prognosis.
authors.affiliation: National Institute of Cardiology, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Szymański
authors.affiliation: National Institute of Cardiology, Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Hryniewiecki
authors.affiliation: National Institute of Cardiology, Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Dąbrowski
authors.affiliation: Institute of Cardiology, Collegium Medicum, Jagiellonian University, Cracow, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Sorysz
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochman
authors.affiliation: National Institute of Cardiology, Warsaw, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Jastrzębski
authors.affiliation: Silesian Center for Heart Disease, Medical University of Silesia, Zabrze, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kukulski
authors.affiliation: Silesian Center for Heart Disease, Medical University of Silesia, Zabrze, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Zembala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000401:mortality*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000401:mortality*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*; D011446:Prospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality*; D016896:Treatment Outcome