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Cerebrovascular events after transcatheter mitral valve interventions: a systematic review and meta-analysis

Gabriel Châteauneuf1, Tamim M Nazif2, Frédéric Beaupré1

  • 1Cardiology, Quebec Heart and Lung Institute, Quebec, Quebec, Canada.

Heart (British Cardiac Society)
|April 19, 2020
PubMed

Insights

Transcatheter mitral valve interventions show low cerebrovascular event rates. Further research is needed to understand stroke mechanisms after mitral valve clip repair and transcatheter mitral valve replacement.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Neurology

Background:

  • Transcatheter mitral valve interventions are increasingly used for high-risk patients with mitral valvulopathy.
  • Cerebrovascular events are a potential concern following these cardiac procedures.

Purpose of the Study:

  • To systematically review and meta-analyze the incidence of cerebrovascular events after transcatheter mitral valve edge-to-edge repair (MTEER) using a mitral valve clip and transcatheter mitral valve replacement (TMVR).

Main Methods:

  • A systematic review and meta-analysis of studies reporting cerebrovascular events post-MTEER and TMVR.
  • Primary endpoint: incidence of cerebrovascular events (periprocedural and non-periprocedural) as defined by the Mitral Valve Academic Research Consortium.
  • Data pooled using a random effect model; study quality assessed with the Hawker checklist.

Main Results:

  • Analysis of 60 studies (28,155 patients) for MTEER: periprocedural stroke rate 0.9%, non-periprocedural stroke rate 2.4%.
  • Analysis of 26 studies (1,910 patients) for TMVR: periprocedural stroke rate 1%, non-periprocedural stroke rate 7%.
  • Overall, transcatheter mitral valve interventions demonstrated low periprocedural stroke rates.

Conclusions:

  • Transcatheter mitral valve interventions are associated with low rates of cerebrovascular events.
  • Mechanisms underlying these cerebrovascular complications require further investigation due to limited high-quality data.
Abstract

Keywords:
meta-analysismitral regurgitationmitral stenosistranscatheter valve interventions

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