Early efficacy of"one-stop"transapical transcatheter aortic valve replacement combined with mitral valve edge-to-edge repair in the treatment of multivalvular disease
Objective To investigate the feasibility and early efficacy of transapical transcatheter aortic valve replacement(TAVR)combined with transcatheter mitral valve edge-to-edge repair(TEER)in patients with high-risk aortic valve lesions combined with severe mitral regurgitation.Methods The clinical data of patients who underwent"one-stop"transapical TAVR+TEER in our hospital from August 2022 to October 2023 were retrospectively analyzed.Results Five patients were collected,including 3 males and 2 females with a mean age of 66.6±1.8 years.Four patients had aortic valve insufficiency combined with mitral regurgitation and one had aortic valve stenosis and insufficiency combined with mitral regurgitation.All patients successfully completed transapical TAVR+TEER,and the immediate postoperative echocardiographic results revealed that none of them had more than mild perivalvular leakage and mitral regurgitation,and the prosthetic valves were in good position and function.At 1 week postoperatively,echocardiographic results showed 5 patients with no displacement of the prosthetic valve,detachment of the mitral clip,or damage to the leaflets.At 1 month postoperatively,cardiac function was improved to varying degrees in 4 patients,and 1 patient died of multiorgan failure.At 2 months postoperatively,1 patient died of cerebrovascular accident,and at 3 months postoperatively the echocardiographic results of the remaining 3 patients revealed that there was no more than mild perivalvular leakage or mitral regurgitation,and the patients'postoperative cardiac function and daily life ability were significantly improved.Conclusion In high-risk aortic valve lesions combined with severe mitral regurgitation,"one-stop"transapical TAVR+TEER is feasible with favorable early efficacy and safety.
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