Relationship between Survival and Cardiac Valve Regurgitation Before and After Invasive Atrio-Ventricular Valve Treatment
Presented During:
Thursday, May 4, 2023: 6:30PM - Saturday, May 6, 2023: 2:29AM
New York Hilton Midtown
Posted Room Name:
Grand Ballroom Foyer
Abstract No:
MP052
Submission Type:
Abstract Submission
Authors:
Tulio Caldonazo (1), Torsten Doenst (1), Tolga Can (1), Gloria Faerber (1), Leoni Riedel (1), Murat Mukharyamov (1), Hristo Kirov (1)
Institutions:
(1) Jena University Hospital, Jena, Germany, Jena, Thuringia
Submitting Author:
Tulio Caldonazo
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Jena University Hospital, Jena, Germany
Jena University Hospital, Jena, Germany
Co-Author(s):
*Torsten Doenst
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Jena University Hospital, Jena, Germany
Jena University Hospital, Jena, Germany
Tolga Can
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Jena University Hospital, Jena, Germany
Jena University Hospital, Jena, Germany
*Gloria Faerber
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Jena University Hospital, Jena, Germany
Jena University Hospital, Jena, Germany
Leoni Riedel
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Jena University Hospital, Jena, Germany
Jena University Hospital, Jena, Germany
Murat Mukharyamov
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Jena University Hospital, Jena, Germany
Jena University Hospital, Jena, Germany
Hristo Kirov
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Jena University Hospital, Jena, Germany
Jena University Hospital, Jena, Germany
Presenting Author:
*Torsten Doenst
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Jena University Hospital, Jena, Germany
Jena University Hospital, Jena, Germany
Abstract:
Objective: The degree of both mitral and tricuspid valve regurgitation correlates with mortality, based on a vicious cycle of increasing regurgitation and decreasing ventricular function. Restoration of valve competence should therefore break this vicious cycle and improve life expectancy. However, complete restoration of valve competence is still considered potentially detrimental by some for its elimination of a "pop-off" mechanism into the low-pressure atrium presumably avoiding pump failure. We reasoned that such a mechanism should offset the preoperative relationship between mortality and valve regurgitation after an invasive procedure.
Methods: We performed a comprehensive literature search to identify contemporary studies reporting long-term outcomes between populations, who were categorized by different degrees of mitral/tricuspid valve regurgitation (none-mild/moderate/severe). MEDLINE delivered 11,601 studies, 110 studies showed direct comparison between the degree of valve regurgitation and survival rates. These studies were included in the distribution plots.
Results: The figure shows that without any invasive procedure increasing degrees of mitral and tricuspid valve regurgitation are associated with worse long-term mortality. Data for structural mitral valve regurgitation without intervention are too sparse to display but individual studies find the same relationship. After invasive procedures (surgery or intervention), the relationship remained the same. It was present in both mitral and tricuspid regurgitation, independent of the regurgitation mechanism and unaffected by differences in invasive procedures performed to treat regurgitation.
Conclusions: The same relationship between the degree of regurgitation and mortality before and after an invasive valve procedure argues against the existence of a pop-off mechanism. In contrast, the results suggest that complete and durable elimination of valve regurgitation interrupts the described vicious cycle and is associated with the longest life expectancy.
Methods: We performed a comprehensive literature search to identify contemporary studies reporting long-term outcomes between populations, who were categorized by different degrees of mitral/tricuspid valve regurgitation (none-mild/moderate/severe). MEDLINE delivered 11,601 studies, 110 studies showed direct comparison between the degree of valve regurgitation and survival rates. These studies were included in the distribution plots.
Results: The figure shows that without any invasive procedure increasing degrees of mitral and tricuspid valve regurgitation are associated with worse long-term mortality. Data for structural mitral valve regurgitation without intervention are too sparse to display but individual studies find the same relationship. After invasive procedures (surgery or intervention), the relationship remained the same. It was present in both mitral and tricuspid regurgitation, independent of the regurgitation mechanism and unaffected by differences in invasive procedures performed to treat regurgitation.
Conclusions: The same relationship between the degree of regurgitation and mortality before and after an invasive valve procedure argues against the existence of a pop-off mechanism. In contrast, the results suggest that complete and durable elimination of valve regurgitation interrupts the described vicious cycle and is associated with the longest life expectancy.
Mitral Conclave:
Degenerative Valve Disease
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