Transcatheter Aortic Valve Replacement in the Presence of Mitral Prosthesis or Ring

ABSTRACTBackground: Data concerning transcatheter aortic valve replacement (TAVR) in patients with prior mitral surgery is limited and preliminary reports seem encouraging. We sought to describe TAVR outcomes in the presence of mitral prosthesis.Methods: Clinical, imaging and angiographic records of patients with previous mitral valve surgery who underwent TAVR in three Israeli tertiary hospitals were analyzed. Amongst the patients, 28 received a balloon-expandable valve, nine received a self-expandable valve, and one received a mechanically-expandable valve. Aorto-mitral distance and angle were obtained from reconstructed multi-sliced CT images. Primary endpoint was a composite of procedural mortality, need for a second valve, complete AV block, significant paravalvular leak (PVL), and intensive care unit (ICU) admission > 5 days.Results: Thirty-eight patients (74% women) with a mean age of 76 ± 7 years underwent TAVR. Euroscore2 and Society of Thoracic Surgeons (STS) score were 12 ± 9% and 6 ± 5%, respe...