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Mitral Valve Clip for Treatment of Mitral Regurgitation: An Evidence-Based Analysis

Mohammed T Ansari1, Nadera Ahmadzai1, Kathryn Coyle2

  • 1Ottawa Hospital Research Institute, Ottawa, Ontario.

Ontario Health Technology Assessment Series
|September 18, 2015
PubMed

Insights

Percutaneous mitral valve clip repair for chronic mitral regurgitation in high-risk patients has inconclusive evidence. More research is needed to determine its effectiveness, harms, and cost-effectiveness compared to surgery.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Health Economics

Background:

  • Chronic mitral regurgitation affects 500,000 North American patients.
  • Many patients are poor candidates for traditional mitral valve surgery.

Purpose of the Study:

  • To investigate the comparative effectiveness, harms, and cost-effectiveness of percutaneous mitral valve repair using mitral valve clips.
  • Focus on patients at prohibitive risk for surgery.

Main Methods:

  • Searched MEDLINE, Embase, Cochrane Library, NHS EED, and Tufts CEA registry (1994-2014).
  • Included systematic reviews, randomized trials, and economic studies.
  • Assessed study validity using Cochrane risk of bias tool and Phillips checklist.

Main Results:

  • Evidence on effectiveness and harms is inconclusive and of very low quality.
  • Percutaneous mitral valve clip repair may offer a survival advantage in the first 1-2 years for some patients.
  • Cost-effectiveness could not be established due to study limitations.

Conclusions:

  • Evidence quality is very low due to risk of bias, indirectness, and imprecision.
  • No meaningful conclusions can be drawn regarding mitral valve clips in prohibitive-risk patients.
Abstract

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