Current cardiology reviews · 2026
Contemporary Review of Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement with Concomitant Mitral Stenosis.
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Butt Asra, Echefu Gift, Geeslin Derek, Ahmad Latifah, Craig Daniel, Ndubisi Olisaemeka, Nayyar Mannu, Ibebuogu Uzoma N
Аннотация
INTRODUCTION: Multivalvular cardiac disease has been associated with increased mortality and morbidity as compared to isolated valve disease. The treatment of choice for combined degenerative aortic and mitral stenotic disease is considered to be double valve surgery, but it is associated with poorer outcomes when compared to isolated valve surgical correction, especially in high-risk populations. There is considerable interest in utilizing transcatheter therapies in multivalvular disease. The prevalence and outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) with concomitant mitral stenosis (MS) have not been studied extensively. Currently, there are no specific recommendations or guidelines for managing these patients.
METHODS: A search of PubMed and Cochrane databases was performed for clinical studies of patients undergoing TAVR for severe AS with concomitant MS.
RESULTS: Our research demonstrates that most patients undergoing TAVR for severe AS with concomitant mitral valve stenosis tend to be elderly with degenerative valve disease. Short-term outcomes, such as postoperative hospital stay, as well as long-term outcomes, such as 1-year mortality, are worse in TAVR with severe MS. TAVR in mild to moderate MS shows no significant differences in outcomes compared with TAVR for isolated severe AS.
DISCUSSION: Most studies have shown that in subjects undergoing TAVR with concomitant MS, severe MS is associated with worse outcomes, while mild to moderate MS shows no significant difference compared with the absence of MS. Limitations of our study are mainly related to the small number of high-quality clinical trials examining TAVR in patients with combined AS and MS.
CONCLUSION: With the aging population, TAVR has been a more attractive option for the treatment of severe symptomatic AS. The optimal treatment of patients with AS along with MS is not clear. Thus, further research is needed in this field.
METHODS: A search of PubMed and Cochrane databases was performed for clinical studies of patients undergoing TAVR for severe AS with concomitant MS.
RESULTS: Our research demonstrates that most patients undergoing TAVR for severe AS with concomitant mitral valve stenosis tend to be elderly with degenerative valve disease. Short-term outcomes, such as postoperative hospital stay, as well as long-term outcomes, such as 1-year mortality, are worse in TAVR with severe MS. TAVR in mild to moderate MS shows no significant differences in outcomes compared with TAVR for isolated severe AS.
DISCUSSION: Most studies have shown that in subjects undergoing TAVR with concomitant MS, severe MS is associated with worse outcomes, while mild to moderate MS shows no significant difference compared with the absence of MS. Limitations of our study are mainly related to the small number of high-quality clinical trials examining TAVR in patients with combined AS and MS.
CONCLUSION: With the aging population, TAVR has been a more attractive option for the treatment of severe symptomatic AS. The optimal treatment of patients with AS along with MS is not clear. Thus, further research is needed in this field.