Transcatheter approach in patients with severe aortic stenosis and concomitant severe mitral regurgitation

Patients with severe aortic valve stenosis who are candidates for transcatheter aortic valve replacement represent a high-risk population for the presence of frequent comorbidities (reduced left ventricular ejection fraction, associated valve insufficiency, right ventricular dysfunction and/or pulmonary hypertension). Aortic valve stenosis can be associated with any other valve defects but among these mitral regurgitation is the most commonly associated valve disease. The simultaneous presence of severe mitral regurgitation in patients with aortic stenosis is a negative prognostic factor, resulting in increased mortality and a high diagnostic complexity, in particular in the accuracy of the evaluation of the two valve defects and therapeutic management which, at present, are not supported by strong scientific evidence.