Comparison of balloon-expandable valve and self-expandable valve in terms of endpoints in patients with transcatheter aortic valve implantation in patients with moderate-severe mitral valve regurgitation

ABSTRACT Aim: Aortic Stenosis (AS) is the most common valvular disease for which valve replacement is performed worldwide. Approximately 20-60% of patients undergoing TAVI within the indication have moderate or severe mitral regurgitation (MR). The aim of our study was to evaluate the survival and endpoints of patients undergoing TAVI according to preoperative risk factors and to compare the effect of the type of valve used on mitral regurgitation. Method: In our study, 179 patients with moderate or severe mitral valve regurgitation who had undergone TAVI between 2013 and 2021 in our hospital and who met the inclusion criteria were included. Procedure notes, death notifications, demographic data, comorbidities, and pre-procedural transthoracic echocardiography (TTE) parameters were analysed. Results: In our group of 179 patients with moderate to severe mitral valve regurgitation, 10 (5.5%) in-hospital deaths were observed. Patients presenting with pulmonary oedema as the presenting clinic were significantly more common in the in-hospital mortality group (p=0.001). In the 3-year follow-up, the mean age was significantly higher in patients with all-cause mortality (p<0.001). Patients with a history of stroke were observed more frequently in the mortality group (p=0.032). Self-expandable valve use was significantly more common in the mortality group (p=0.047). Among the patients with pre-procedure intermediate-advanced MR, those who used balloon expandable had more improvement than those who used self-expandable (p=0.046). When patients were compared in terms of 3-year mortality according to the change in valve regurgitation level, a significantly higher number of deaths were observed in the group with increasing LV (p=0.002). Conclusion: AS patients undergoing TAVI are frequently accompanied by moderate-severe MR. Although there is a significant decrease in the rate of moderate-severe MR after TAVI, the etiology of MR is important in this respect. Reduction in MR reduces long-term mortality and hospitalisations. Keywords: TAVI, balloon-expandable, self-expandable, mitral regurgitation