Impact of Mitral Surgery for Mitral Regurgitation on Coexisting Aortic Regurgitation

Background: There is no clear finding on the course of coexisting aortic regurgitation (AR) after treatment of mitral regurgitation (MR). We investigated the effect of mitral surgery for MR on coexisting AR. Methods: Between January 2008 and December 2016, 75 patients underwent mitral surgery for MR coexisting mild AR. Of these, 65 patients who were available to follow-up postoperative echocardiographic tests 1 year after surgery were included in the present study. Patients were divided into two groups according to the degree of postoperative AR. We investigated the predictive factors for continued AR and perioperative cardiac function. Results: In all, 22 patients' AR improved and became less than mild and 43 patients' persisted at mild or increased. The predictive factor for continued AR was left atrial diameter >50 mm (P = 0.021, odds ratio = 4.739, 95% confidence interval: 1.259-17.846) in multivariate logistic regression analysis. No patients underwent reoperation for continued AR in both groups. However, one patient was rehospitalized for heart failure in the continued AR group. Conclusion: Left atrial diameter may be an important prognostic factor for continued AR after mitral surgery for MR. MR with mild AR should be treated as soon as before the left atrium expands.