May 2025 - Caglayan Demirel

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DDr. Caglayan Demirel

MedUni Wien RESEARCHER OF THE MONTH May 2025

Mixed aortic valve disease (MAVD) is increasingly observed in patients undergoing transcatheter aortic valve replacement (TAVR), yet evidence regarding its long-term outcomes remains limited. Utilizing the Vienna TAVR Registry, we analyzed 880 patients treated between 2007 and 2020. MAVD was prevalent in over 70% of cases and was significantly associated with a higher risk of paravalvular regurgitation (PVR) compared to isolated aortic stenosis. Notably, both MAVD and the presence of ≥ mild PVR independently predicted worse long-term survival. These findings emphasize the prognostic relevance of MAVD in the TAVR population, suggesting that earlier intervention strategies may be needed to improve patient outcomes.

Selected Literature

1. Mixed aortic valve disease: Association with paravalvular leak and reduced survival after TAVR. Eur Heart J Cardiovasc Imaging. 2024 Jan 17:jeae005. doi: 10.1093/ehjci/jeae005. Epub ahead of print. PMID: 38236149, Demirel C*, Winter MP, Nitsche C, Koschatko S, Jantsch C, Mascherbauer K, Halavina K, Heitzinger G, Dona C, Dannenberg V, Spinka G, Koschutnik M, Andreas M, Hengstenberg C, Bartko PE.
2. Impact of stroke history on procedural cerebrovascular insult probability and long-term outcome after TAVI. Eur J Clin Invest. 2024 Jan;54(1):e14099. doi: 10.1111/eci.14099. Epub 2023 Sep 28. PMID: 37771050, Demirel C*, Sulzgruber P, Winter MP, Mascherbauer K, Halavina K, Heitzinger G, Dona C, Koschatko S, Jantsch C, Andreas M, Hengstenberg C, Bartko PE.
3. Long-term risk of unplanned percutaneous coronary intervention after transcatheter aortic valve replacement. EuroIntervention. 2022 Nov 18;18(10):797-803. doi: 10.4244/EIJ-D-22-00342. PMID: 36039573; PMCID: PMC9725053, Okuno T, Demirel C*, Tomii D, Heg D, Häner J, Siontis GCM, Lanz J, Räber L, Strotecky S, Fürholz M, Praz F, Windecker S, Pilgrim T.
4. Risk and Timing of Noncardiac Surgery After Transcatheter Aortic Valve Implantation. JAMA Netw Open. 2022 Jul 1;5(7):e2220689. doi: 10.1001/jamanetworkopen.2022.20689. PMID: 35797045; PMCID: PMC9264039, Okuno T, Demirel C*, Tomii D, Erdoes G, Heg D, Lanz J, Praz F, Zbinden R, Reineke D, Räber L, Stortecky S, Windecker S, Pilgrim T.
5. Total Muscle Area and Visceral Adipose Tissue Measurements for Frailty Assessment in TAVR Patients. J Clin Med. 2024 Feb 26;13(5):1322. doi: 10.3390/jcm13051322. PMID: 38592183; PMCID: PMC10932166, Demirel C*, Rothenbühler CF, Huber M, Schweizer M, Todorski I, Gloor DA, Windecker S, Lanz J, Stortecky S, Pilgrim T, Erdoes G.
6. Low Bone Mineral Density on Computed Tomography: Association with Poor Survival after Transcatheter Aortic Valve Replacement. J Clin Med. 2024 May 3;13(9):2698. doi: 10.3390/jcm13092698. PMID: 38731227, Demirel C*, Halavina K, Hamzaraj K, Klement J, El-Shaer M, Hemetsberger R, Winter MP, Koschatko S, Jantsch C, Andreas M, Loewe C, Kammerlander A, Hengstenberg C, Bartko PE.