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Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry Prognostic Value of Computed Tomography-Derived Extracellular Volume in TAVR Patients With Low-Flow Low-Gradient Aortic Stenosis Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Rheumatic Aortic Stenosis Safety and Efficacy of Transcatheter Aortic Valve Replacement With Continuation of Vitamin K Antagonists or Direct Oral Anticoagulants Stroke Complicating Infective Endocarditis After Transcatheter Aortic Valve Replacement 5-Year Outcomes Comparing Surgical Versus Transcatheter Aortic Valve Replacement in Patients With Chronic Kidney Disease Empagliflozin, Health Status, and Quality of Life in Patients with Heart Failure and Preserved Ejection Fraction: The EMPEROR-Preserved Trial Evaluation and Management of Aortic Stenosis in Chronic Kidney Disease: A Scientific Statement From the American Heart Association Edoxaban versus Vitamin K Antagonist for Atrial Fibrillation after TAVR Outcomes of procedural complications in transfemoral transcatheter aortic valve replacement

Review ArticleVolume 13, Issue 13, July 2020

JOURNAL:JACC Cardiovasc Interv. Article Link

Transcatheter Aortic Valve Replacement in Patients With Multivalvular Heart Disease

F Khan, T Okuno, D Malebranche et al. Keywords: aortic regurgitation; mitral regurgitation; mitral stenosist; TAVR; tricuspid regurgitation

ABSTRACT

As transcatheter aortic valve replacement becomes a more dominant treatment option across all risk profiles, the frequency of encountering patients with multivalvular disease will increase. Furthermore, percutaneous interventions to treat other valvular lesions are also evolving. Understanding the clinical implications and treatment options for a second valvular lesion is becoming increasingly important to guide heart team decisions, and this paper aims to review the evidence around these situations. Diagnosis of multivalvular disease can be challenging because of changes in physiology. There are little randomized data to guide therapy in multivalvular disease. Multidisciplinary heart team decisions can be invaluable in integrating the plethora of clinical, hemodynamic, and imaging data on which an optimal management strategy can be planned. Prospective studies to assess the role of structural valve interventions in the transcatheter aortic valve replacement era would greatly help improve outcomes for structural heart patients.