Aortic valve replacement without mitral intervention in patients with severe aortic stenosis and mild-to-moderate mitral disease from MAC resulted in no significant change in MS or MR severity.
Cohort (n=147)
No
Does aortic valve replacement (AVR) without mitral intervention lead to progression of mitral valve disease in patients with severe aortic stenosis and concomitant mitral annular calcification?
In patients with severe aortic stenosis and concomitant mild-to-moderate mitral valve disease from mitral annular calcification, isolated aortic valve replacement does not lead to significant progression of mitral disease over a median 2-year follow-up.
p-value: p=0.47
BACKGROUND: Patients with severe aortic valve stenosis and concomitant mild to moderate mitral stenosis (MS) or mitral regurgitation (MR) from mitral annular calcification (MAC) often undergo aortic valve replacement (AVR) while sparing the mitral valve. This study aimed to analyze the rate of progression of mitral valve disease in patients with MAC undergoing AVR. METHODS: A retrospective cohort study was conducted on 147 patients with MS and/or MR and MAC undergoing AVR at Allina Health in 2012-2022. The rate of progression for MR, MS, left ventricular ejection fraction (LVEF), and survival probability were assessed at a median follow-up of 2.0 (1.24-3.70) years. RESULTS: The mean age was 78 ± 10 years. Most patients were female (66%) with NYHA class III symptoms (70%) prior to AVR, and the majority underwent TAVR (93%). Most patients had MS ranging from trace to moderate range (90%) and MR ranging from trace to moderate range (91%) prior to the procedure. There was no significant change in MS or MR severity, or mortality (p = 0.47) based on MAC severity within the follow up duration. CONCLUSION: Overall, patients with MAC with moderate or less MS and/or MR and aortic stenosis had no significant change in MS or MR severity and no need for mitral valve intervention during 6 years of follow-up after AVR.
Abdul-Kafi et al. (2026) conducted a cohort in Severe aortic valve stenosis with concomitant mild to moderate mitral stenosis or regurgitation from mitral annular calcification (n=147). Aortic valve replacement (AVR) sparing the mitral valve was evaluated on Rate of progression for MR, MS, left ventricular ejection fraction (LVEF), and survival probability (p=0.47). Aortic valve replacement without mitral intervention in patients with severe aortic stenosis and mild-to-moderate mitral disease from MAC resulted in no significant change in MS or MR severity.