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Risk factors for residual mitral regurgitation after aortic valve replacement in patients with severe aortic valve stenosis and moderate mitral regurgitation

  • Yasushige ShinguEmail author
  • Hiroyuki Iwano
  • Tatsuya Murakami
  • Nobuyasu Katoh
  • Tomonori Ooka
  • Hiroki Katoh
  • Suguru Kubota
  • Yoshiro Matsui
Original Article
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Abstract

Objectives

While it was reported that patients with residual moderate mitral regurgitation (MR) after surgical aortic valve replacement (SAVR) had a poorer prognosis than those without it, the risk factors for residual MR have not been fully elucidated. The aim of the study was to evaluate risk factors for residual MR after SAVR.

Methods

Of the 222 patients who underwent isolated SAVR from 2001 to 2018, 33 (11 men; age: 74 ± 7 years) had functional moderate MR before surgery. The risk factors for residual MR were evaluated by comparing patients with residual moderate MR (n = 11, 33%) with those who exhibited improved post-surgery MR (n = 22, 67%).

Results

The left atrial diameter was significantly larger in the residual MR group (51 ± 7 mm) than in the improved MR group (46 ± 5 mm; P = 0.049). The mean pressure gradient at the aortic valve was significantly smaller in the residual MR group (52 ± 18 mmHg) than in the improved MR group (69 ± 22 mmHg; P = 0.043). A ratio of left atrial diameter (mm) and mean aortic valve pressure gradient (mmHg) greater than 0.9 predicted residual MR with a sensitivity of 70% and a specificity of 74% (area under the ROC curve: 0.779; P = 0.015).

Conclusions

In patients with severe aortic valve stenosis and moderate MR, a high ratio of preoperative left atrial diameter and mean aortic valve pressure gradient would be a parameter predicting residual moderate MR post-SAVR.

Keywords

Aortic valve stenosis Mitral regurgitation 

Notes

Acknowledgements

We would like to thank Editage (http://www.editage.jp) for English language editing.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest, financial or otherwise.

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Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  • Yasushige Shingu
    • 1
    Email author
  • Hiroyuki Iwano
    • 2
  • Tatsuya Murakami
    • 3
  • Nobuyasu Katoh
    • 1
  • Tomonori Ooka
    • 1
  • Hiroki Katoh
    • 4
  • Suguru Kubota
    • 1
  • Yoshiro Matsui
    • 1
  1. 1.Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
  2. 2.Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
  3. 3.Department of Thoracic SurgeryAsahikawa City HospitalAsahikawaJapan
  4. 4.Emergency and Critical Care CenterHokkaido University HospitalSapporoJapan

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