Impact of Mitral Annular Calcium and Mitral Stenosis on Outcomes After Transcatheter Aortic Valve Implantation
Section snippets
Methods
From January 2008 to May 2018, we evaluated 1,239 patients who consecutively underwent TAVI in a French university hospital. We excluded 62 patients because of the presence of a mitral prosthesis in 23 and lack of computed tomography (CT) scan in 39. Thus, the final study population consisted of 1,177 patients. Data were prospectively collected in a local electronic database using the RedCap platform, with the exception of the CT-scan data on MAC, which were retrospectively collected. Patients
Results
Among 1177 patients, 504 (42.8%) had a MAC (Figure 1). Table 1 shows the baseline characteristics and procedural data of the study population according to the presence of MAC. Patients with MAC were more frequently women had a higher prevalence of diabetes, previous chest radiation and porcelain aorta. They more frequently had mitral regurgitation and MS. The procedural findings were similar between groups.
Thirty-day outcomes according to the presence of MAC are shown in Table 2. The rates of
Discussion
The evaluation of combined aortic stenosis and MS is challenging in patients with MAC-MS.19 The continuity equation is flow-dependent and can overestimate MS if concomitant severe aortic stenosis is associated and is not measurable when aortic or mitral regurgitation are present.19 Pressure half-time is unreliable with concomitant aortic stenosis or aortic regurgitation.20 MAC may compromise the accuracy of planimetry. The inflow proximal isovelocity surface area is operator-dependent and
Disclosures
Jules Mesnier is supported by a research grant from the Fédération Française de Cardiologie and received consultancy fees from Owkin
Eric Brochet is proctor for Abbott Vascular
Bernard Iung is consultant for Edwards Lifesciences
Dominique Himbert is proctor for Edwards Lifesciences and Abbott Vascular
The other authors do not declare any disclosure
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Funding Sources: None.