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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Stroke after transcatheter edge-to-edge mitral valve repair: a systematic review and meta-analysis

Patricia Barros da Silva1, José P Sousa, Bárbara Oliveiros

  • 1Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|December 13, 2019
PubMed

Insights

Transcatheter mitral valve repair (TMVR) shows a trend toward lower stroke risk compared to surgical mitral valve repair (SMVR), with similar stroke rates to optimal medical treatment (OMT) for severe mitral regurgitation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Severe mitral regurgitation necessitates effective treatment to prevent adverse outcomes.
  • Transcatheter mitral valve repair (TMVR) offers a less invasive alternative to surgical repair.
  • Comparing stroke rates across different mitral valve repair strategies is crucial for patient management.

Purpose of the Study:

  • To evaluate and compare the stroke rate following TMVR using the MitraClip device.
  • To compare TMVR outcomes against surgical mitral valve repair (SMVR) and optimal medical treatment (OMT).

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, Embase, Cochrane).
  • Random-effects and cumulative meta-analysis of ten studies involving 1,881 patients.
  • Stroke incidence was pooled and analyzed for TMVR vs. SMVR and TMVR vs. OMT.

Main Results:

  • No statistically significant difference in stroke incidence was observed between TMVR and SMVR (OR 0.49, p=0.19), though a trend favored TMVR.
  • TMVR demonstrated a similar stroke rate compared to OMT (OR 1.09, p=0.79).
  • De novo atrial fibrillation was more frequent after SMVR than TMVR.

Conclusions:

  • While not statistically significant, TMVR showed a trend towards a lower stroke rate post-procedure compared to SMVR.
  • TMVR and OMT yielded comparable stroke rates for severe mitral regurgitation.
  • TMVR may offer a favorable stroke profile in managing mitral regurgitation.
Abstract

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