Table 2.
Clinical information about AV of the four patients who progressed to severe aortic stenosis.
| Patient A | Patient B | Patient C | Patient D | |
|---|---|---|---|---|
| Age at 1st MV intervention | 33 | 66 | 60 | 43 |
| Sex | Female | Female | Female | Female |
| Follow-up (years) | 7 | 4 | 18 | 28 |
| AV profile on the preop. exam | ∗Moderate AS | Moderate AS moderate AR (II/IV) | ∗Mild AS | ∗Missing |
| Valve intervention | PMBV for severe MS | Mechanical MVR + tricuspid valvuloplasty for severe MS and moderate TR | ∗Tissue MVR + tricuspid annuloplasty + maze for severe MS and TR | PMBV mechanical MVR, tricuspid valvuloplasty, and maze operation for severe MS and severe TR |
| AV profile on the last exam | High-gradient severe AS Mild AR (I/IV) | High-gradient severe AS moderate AR (II/IV) | Paradoxical LFLG severe AS (VTILVOT/VTIAV = 0.25) Mild AR (I/IV) | Paradoxical LFLG severe AS (VTILVOT/VTIAV = 0.17) Mild AR (I/IV) |
| Additional valve intervention | DVR for severe MS and severe AS | No | DVR + maze for infective endocarditis | No |
Note: As Patients A, C, and D underwent initial MV intervention at other institutions, much data are lacking. Patient C underwent DVR with maze operation not only because AS was severe but also because both MV and AV were involved with infective endocarditis. Patient D seems to have true-severe AS when the dimensionless parameter was integrated to assess the AS severity. Patients B and D are being followed with medical therapy including diuretics and show no limitation on daily activities. The term “preop.” refers to the assessment conducted just before MV surgery, and “last” refers to the most recent echocardiographic assessment conducted prior to the AV intervention, aside from the one-year follow-up.
Abbreviations: AR, aortic regurgitation; AS, aortic stenosis; AV, aortic valve; DVR, dual valve replacement (mitral and aortic valve replacement); LFLG, Low-flow low-gradient; LVOT, left ventricular outflow tract; MR, mitral regurgitation; MS, mitral stenosis; MV, mitral valve; MVR, mitral valve replacement; op., operation; PMBV, percutaneous mitral balloon valvuloplasty; TTE, transthoracic echocardiography; VTI, velocity-time integral.
∗Incomplete or missed data (data obtained from other hospitals).