Open Access Opinion Article August 16, 2024

8 Pages

The strategy for bivalvular interventions in aortic stenosis and concomitant mitral regurgitation

Authors

Elena Golukhova1 , Inessa Slivneva2,*, Karen Petrosyan3 , Magomedrasul Musaev4 , Yuliya Pirushkina5 , Mikhail Latyshev6 , Arslan Magammatov7 , Khadizha Patsoeva8

  1. Bakulev National Medical Research Center for Cardiovascular Surgery
  2. Bakulev National Medical Research Center for Cardiovascular Surgery
  3. Bakulev National Medical Research Center for Cardiovascular Surgery
  4. Bakulev National Medical Research Center for Cardiovascular Surgery
  5. Bakulev National Medical Research Center for Cardiovascular Surgery
  6. Bakulev National Medical Research Center for Cardiovascular Surgery
  7. Bakulev National Medical Research Center for Cardiovascular Surgery
  8. Bakulev National Medical Research Center for Cardiovascular Surgery
  9. * Author to whom correspondence should be addressed.

Journal of Heart Valve Disease Innovation 2024, 29(1), 37-44; https://doi.org/10.36923/jhvd.v29i1.211

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Abstract

Multivalvular heart disease represents a less explored domain within cardiovascular surgery. In patients with aortic stenosis (AS) undergoing surgical or transcatheter aortic valve replacement (TAVR), the prevalence of moderate to severe mitral regurgitation (MR) ranges from 8% to 33%. Among the most common presentations are patients with severe AS and clinically significant functional MR. In instances of moderate surgical risk, open-heart surgery is typically performed, sometimes involving combined valve correction procedures. However, for patients deemed to be at high surgical risk or deemed inoperable, an interventional approach may be considered if the anatomy of both the aortic and mitral valves is conducive to such intervention. Careful analysis of each patient is essential in determining the appropriate treatment strategy, whether it involves isolated TAVR or if a staged intervention targeting the aortic and mitral valves is warranted. In the article, we present a review of the literature devoted to the strategy for bivalvular interventions in patients of high surgical risk and also a clinical case of a successful step-by-step interventional approach in an 83-year-old patient of high surgical risk with hemodynamically significant aortic and mitral valve disease, along with an analysis of the chosen approach.

Article information

Keywords
Aortic stenosisСoncomitant mitral regurgitationBivalvular interventionTranscatheter Aortic Valve ReplacementTranscatheter Edge-to-Edge Mitral Valve Repairpatients of high surgical risk
Section
Articles
Issue
Vol. 29 No. 1 (2024)
Submitted
June 27, 2024
Accepted
August 6, 2024
Published
August 16, 2024
Corresponding author
Inessa Slivneva
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