Incidental moderate mitral regurgitation in patients undergoing aortic valve replacement for aortic stenosis: review of guidelines and current evidence

Abstract

Recent evidence has shown that moderate mitral regurgitation is common and clinically relevant in patients presenting for surgical and transcatheter aortic valve replacement for aortic stenosis. Prospective multicenter clinical trials are now indicated to resolve the clinical equipoise about whether or not mitral valve intervention also is indicated at the time of aortic valve intervention. Advances in three-dimensional transesophageal echocardiography, transcatheter mitral interventions, and surgical aortic valve replacement, including the advent of sutureless valves, likely will expand the therapeutic possibilities for moderate mitral regurgitation in the setting of aortic valve interventions for severe aortic stenosis.

Keywords: aortic stenosis; clinical outcomes; effective orifice area; guidelines; minimally invasive aortic valve replacement; mitral valve repair; mitral valve replacement; moderate mitral regurgitation; regurgitant fraction; regurgitant volume; surgical aortic valve replacement; sutureless aortic valves; three-dimensional transesophageal echocardiography; transcatheter aortic valve replacement; transcatheter mitral valve interventions; vena contracta.