The fate of untreated moderate rheumatic aortic valve incompetence after mitral valve surgery: A one-year follow-up study

Background

Most of the previous studies agreed that the moderate aortic Regurgitation (AR) has a slow progression over a very long period of time. There is no major consensus on how to deal with concomitant moderate rheumatic AR during mitral valve surgery. The current work evaluates the course of untreated moderate rheumatic AR following mitral valve surgery over a period of 1 year.

Methods

We prospectively enrolled 30 patients who had moderate rheumatic AR associated with pure rheumatic mitral stenosis in 15 patients (group S) and 15 patients with pure rheumatic mitral incompetence (group R). Quantification of the degree of the AR was done by echocardiography using the percentage of the width of the regurgitant get to the width of the left ventricular outflow tract (LVOT) method. Clinical and echocardiographic follow-up were done over 1 year.

Results

There were no early or late postoperative deaths and we achieved 100% follow-up. No patient had aortic valve replacement (AVR) after one year. Preoperatively, the width of the regurgitant jet was 34.67 ± 2.72% and 35.73 ± 1.87% in group S and group R respectively with no statistically significant difference (p = 0.22). Postoperatively after 1 year follow up the width of the regurgitant jet in group S increased significantly to 37.27 ± 4.67% (p = 0.005), while in group R almost remained unchanged 34.73 ± 4.13% (p = 0.3). However. both figures are still in the moderate category between (≥25 to ≤64%).

Conclusions

After 1-year follow-up, the moderate rheumatic AR didn't increase to the severe category necessitating AVR. Longer follow-up duration is recommended.