Valvular & structural heart disease
Mitral Regurgitation after TAVR: Sex Differences and Low-Flow Low-Gradient Aortic Stenosis
Authors' conclusion
More than half of TAVR patients with moderate or severe MR experience MR improvement post-TAVR. Women and those with severe MR are less likely to have a significant improvement in MR. Patients with LFLG AS and persistent moderate or severe MR have worse survival post-TAVR.
Study context
- Population
- TAVR patients with severe aortic stenosis (AS) and moderate or greater mitral regurgitation (MR) pre-TAVRconsecutive TAVR patients with severe AS and moderate or greater MR pre-TAVR
- Participants
- 344 patients
- Exposure
- Patients were stratified by AS subtype
- Outcome
- Baseline characteristics
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Mean age
81.9 years
Females
48.5%
Low-flow low-gradient (LFLG) AS
45.1%
Observational data: associations, not effects.
Further findings
MR improvement post-TAVR
- MR improved by ≥1 grade
- 62.8%
- MR improved to mild or less
- 52.9%
- Similar rates in classic vs LFLG AS
Factors associated with MR improvement to mild or less (multivariable)
- Severe (vs moderate) baseline MR, hypertension, and female sex independently associated with lower odds of MR improvement to mild or less
- In LFLG AS, female sex and severe MR remained significant predictors of persistent MR
- In LFLG AS, higher pre-TAVR aortic valve mean gradient associated with improved MR
Mortality
- Residual severe MR was associated with increased mortality, driven by those with LFLG AS
- Cox proportional hazards models adjusted for clinical and echocardiographic covariates
Original publication
Mitral Regurgitation after TAVR: Sex Differences and Low-Flow Low-Gradient Aortic Stenosis. JACC Adv. Published September 2026. doi:10.
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