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

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 (β: −.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. [ABSTRACT FROM AUTHOR]