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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

The Fate of Mitral Valve Regurgitation After TAVI

  • Karin Steiner1,2
  • Melchior Burri1,2
  • Nina Feirer1,2
  • Tobias Rheude3
  • Hendrik Ruge1,2
  • Markus Krane1,2,4
  • Keti Vitanova1,2
4 affiliations
  1. 1Department of Cardiovascular Surgery, TUM University Hospital German Heart Center Munich, Technical University Munich, 80636 Munich, Germany
  2. 2Department of Cardiovascular Surgery, INSURE (Institute of Translational Cardiac Surgery), TUM School of Medicine and Health, Technical University Munich, 80636 Munich, Germany
  3. 3Department of Cardiology, TUM University Hospital German Heart Center Munich, Technical University Munich, 80636 Munich, Germany
  4. 4DZHK (German Center for Cardiovascular Research) Partner Site Munich Heart Alliance, 80636 Munich, Germany
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Abstract

Background: Outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis with concomitant severe mitral regurgitation (MR) remain incompletely defined. This study aimed to quantify the evolution of high-grade MR after TAVI, compare changes using MR etiology, and assess associations between MR etiology, early improvement, or residual discharge MR and mortality. Methods: In a retrospective single-center cohort, 112 TAVI patients with baseline more-than-moderate MR were included (functional n = 94; degenerative n = 18). MR grade was assessed pre-TAVI, at discharge, and at last available follow-up (serial studies up to ≥5 years), and 5-year all-cause mortality was analyzed. Results: At discharge, 34% of patients improved by more than one MR grade, and 26% by one grade. Among 45 patients with available late echocardiographic follow-up, 62% improved by more than one grade, 24% by one grade. Exploratory five-year survival analyses did not demonstrate a significant difference for MR etiology (p = 0.23), discharge MR grade (p = 0.11), or MR improvement status (p = 0.12). Conclusions: Among patients surviving to longitudinal echocardiographic follow-up, MR reduction was frequently observed after TAVI. Exploratory analyses did not demonstrate statistically significant differences in 5-year survival according to MR etiology, early MR improvement, or discharge MR severity. However, limited sample size and incomplete follow-up preclude definitive prognostic conclusions. Overall, these findings are compatible with a surveillance-first management, and with individualized consideration of adjunctive mitral therapy for persistent higher-grade symptomatic MR.

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Cite

BibTeXRIS
BibTeX
@article{steiner2026fate,
  title = {{The Fate of Mitral Valve Regurgitation After TAVI}},
  author = {Karin Steiner and Melchior Burri and Nina Feirer and Tobias Rheude and Hendrik Ruge and Markus Krane and Keti Vitanova},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218259},
  url = {https://www.mdpi.com/2077-0383/15/21/8259},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The Fate of Mitral Valve Regurgitation After TAVI
AU  - Karin Steiner
AU  - Melchior Burri
AU  - Nina Feirer
AU  - Tobias Rheude
AU  - Hendrik Ruge
AU  - Markus Krane
AU  - Keti Vitanova
PY  - 2026
DA  - 2026/10/23
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218259
UR  - https://www.mdpi.com/2077-0383/15/21/8259
AB  - Background: Outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis with concomitant severe mitral regurgitation (MR) remain incompletely defined. This study aimed to quantify the evolution of high-grade MR after TAVI, compare changes using MR etiology, and assess associations between MR etiology, early improvement, or residual discharge MR and mortality. Methods: In a retrospective single-center cohort, 112 TAVI patients with baseline more-than-moderate MR were included (functional n = 94; degenerative n = 18). MR grade was assessed pre-TAVI, at discharge, and at last available follow-up (serial studies up to ≥5 years), and 5-year all-cause mortality was analyzed. Results: At discharge, 34% of patients improved by more than one MR grade, and 26% by one grade. Among 45 patients with available late echocardiographic follow-up, 62% improved by more than one grade, 24% by one grade. Exploratory five-year survival analyses did not demonstrate a significant difference for MR etiology (p = 0.23), discharge MR grade (p = 0.11), or MR improvement status (p = 0.12). Conclusions: Among patients surviving to longitudinal echocardiographic follow-up, MR reduction was frequently observed after TAVI. Exploratory analyses did not demonstrate statistically significant differences in 5-year survival according to MR etiology, early MR improvement, or discharge MR severity. However, limited sample size and incomplete follow-up preclude definitive prognostic conclusions. Overall, these findings are compatible with a surveillance-first management, and with individualized consideration of adjunctive mitral therapy for persistent higher-grade symptomatic MR.
SN  - 2077-0383
ER  -