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Transcatheter aortic-valve replacement with a self-expanding prosthesis Late kidney injury after transcatheter aortic valve replacement Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Implantation Frailty and Bleeding in Older Adults Undergoing TAVR or SAVR: Insights From the FRAILTY-AVR Study Precision Medicine in TAVR: How to Select the Right Device for the Right Patient Prevalence and clinical implications of valvular calcification on coronary computed tomography angiography Health Status after Transcatheter vs. Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis Contemporary real-world outcomes of surgical aortic valve replacement in 141,905 low-risk, intermediate-risk, and high-risk patients Prevalence and Outcomes of Concomitant Aortic Stenosis and Cardiac Amyloidosis Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis

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.