Valvular & structural heart disease
Mixed aortic valve disease: association with paravalvular leak and reduced survival after transcatheter aortic valve replacement
Main finding · PVRResult — go to the resultOdds ratio 2.06 95% CI 1.51–2.81Authors' conclusion
MAVD is prevalent among TAVR patients and presents unique challenges, with increased PVR risk and worse outcomes compared with isolated AS. Long-term survival for MAVD patients, not limited to those developing PVR post-TAVR, is compromised.
Study context
- Population
- Patients undergoing transcatheter aortic valve replacement (TAVR) at Medical University of Vienna, January 2007–May 2020, with TTE before and after TAVRVienna TAVR registry
- Participants
- 880 patients
- Exposure
- Mixed aortic valve disease (MAVD) vs isolated aortic stenosis (AS)
- MAVDn = 647
- Outcome
- Prevalence of MAVD, association with paravalvular regurgitation (PVR), and long-term mortality after TAVR
Methodological detailssingle-centre
- Single-centre
Main finding
PVR
Odds ratio
2.06
95% CI 1.51–2.81
P = <0.001
Events by group
MAVD
73.52%
647
MAVDvs Isolated AS
OR 2.06 (95% CI 1.51–2.81); P = <0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Mortality with more than mild PVR after TAVRvs no PVRMore than mild PVR in 168 of 880 (19.09%) | 1.33 (1.05–1.67) | P = 0.016 | |
| Mortality in MAVD with ≥ mild PVR after TAVRvs no PVR (subgroup) | 1.30 (1.04–1.62) | P = 0.022 | |
| 0.512Hazard ratio (log scale) |
Original publication
Mixed aortic valve disease: association with paravalvular leak and reduced survival after transcatheter aortic valve replacement. Eur Heart J Cardiovasc Imaging. Published 17 January 2024. doi:10.
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