Balloon aortic valvuloplasty for severe aortic stenosis may reduce mitral regurgitation in mid-term follow-up

INTRODUCTION: Mitral regurgitation (MR) is a frequent complication in patients with severe aortic stenosis (AS). MATERIAL AND METHODS: Echocardiographic assessment of MR was performed at baseline, at 30 days and at 6 months after balloon aortic valvuloplasty (BAV). RESULTS: Data of 271 patients were included in our final analysis, of which 21.2% (n = 85) had at least moderate MR at baseline (in 19 (22.3%) subjects MR was diagnosed as primary). Both groups showed similar severity of AS, but patients in the MR group had a greater left ventricle (LV) size (p = 0.003 for LVESD, p = 0002 for LVEDD) and slightly lower LV ejection fraction (p = 0.04). Mitral regurgitation parameters significantly improved both at 30 days and 6 months after BAV in the MR group (MR jet area: 7.2 (4.5–9.9) vs. 3.6 (2.3–7.2) cm(2), and 7.2 (4.5–9.9) vs. 3.2 (2.1–6.7) cm(2); %MR/left atrial area 34.5 (23.4–42.7) vs. 17.5 (9.3–29.5) and 34.5 (23.4–42.7) vs. 14.5 (8.3–24.5), p < 0.001 for all). In multivariate logistic regression analysis, the change at 30 days, from baseline, in the LVESD (OR = 1.87; 95% CI: 1.23–2.87; p < 0.001) and LVEF (OR = 0.95; 95% CI: 0.87–1.01; p < 0.001); MR jet area (OR = 2.2, 95% CI: 1.5–4.6; p < 0.001) and the presence of primary MR (OR = 3.2, 95% CI: 1.04–5.98; p < 0.001) were retained as independent predictors of significant persisting MR at 6 months. CONCLUSIONS: Balloon aortic valvuloplasty may reduce MR in mid-term follow-up. Predictors of persistent MR at 6 months after BAV included an increase of LVESD and MR jet area and decrease of LVEF at 30 days.