The effect of stent and decalcification on mitral annular motion after aortic valve replacement.

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the changes in mitral annular motion after surgery in patients with aortic stenosis. METHODS: Patients receiving Edwards (Edwards) valves were included in the study. Echocardiographic findings were compared among the three treatments postoperatively, at discharge, and at 1 year after the surgery. Mitral annular motion was evaluated by e prime, using tissue doppler imaging. RESULTS: There were 111 patients receiving Inspiris, 30 patients receiving Intuity and 241 patients receiving Sapien 3. The patients receiving Sapien 3 were significantly older, (Inspiris 71 ± 6.7 years vs. Intuity 75 ± 5.2 years vs. Sapien 3 84 ± 5.1 years, p < .001), and prevalence of hemodialysis were significantly higher in patients receiving Intuity (Inspiris 11.7% vs. Intuity 46.7% vs. Sapien 3 0.0%, p < .001). There was a significant improvement in mean pressure gradient in all groups (Inspiris 55 ± 21.2-13 ± 5.2 mmHg, p < .001; Intuity 48 ± 17.6-12 ± 4.9 mmHg, p < .001, Sapien 3 55 ± 16.6-14 ± 5.2 mmHg, p < .001). Decalcification was associated with increase in e prime after surgery (no decalcification 0.10 ± 1.280 cm/s vs. decalcification 0.68 ± 1.405 cm/s, p < .001) Further, existence of stent was associated with less increase in e prime after surgery (no stent 0.83 ± 1.210 cm/s vs. stent 0.10 ± 1.356; p < .001). Multivariate analysis showed that existence of stent but not decalcification of the aortic valve was independently associated with changes in e prime after surgery (ß -.4679, 95% confidence interval -0.93389 to -0.00200, p = .049). CONCLUSIONS: Although improvement in pressure gradient was achieved in all treatments, existence of stent inhibited mitral annular motion after surgery.