Outcomes after Transcatheter Mitral Valve Edge to Edge Repair; a Comparison of Two Pathologies

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Transcatheter mitral valve repair (TMVR) is increasingly utilized.
• Comparing outcomes in functional mitral regurgitation (FMR) versus degenerative mitral regurgitation (DMR) is crucial.
• The edge-to-edge technique is a primary TMVR method.

Purpose of the Study:

• To compare clinical and echocardiographic outcomes of TMVR with the edge-to-edge technique in FMR and DMR patients.
• To correlate clinical and echocardiographic measurements post-procedure.
• To assess the long-term efficacy of TMVR.

Main Methods:

• A retrospective study of 111 patients undergoing the MitraClip procedure (2012-2018).
• Patients were categorized into FMR (n=88) and DMR (n=23) groups.
• Clinical and echocardiographic data were analyzed.

Main Results:

• Advanced age and FMR were associated with longer hospital and CCU stays.
• Severe renal impairment, female gender, and history of stroke negatively impacted survival.
• MitraClip significantly improved MR grade, with comparable effectiveness in FMR and DMR, but improvements in LV dimensions and PASP were not sustained.
• Moderate residual MR, lower EuroSCORE, and lack of beta-blockers predicted MR recurrence.

Conclusions:

• The MitraClip procedure provides sustainable symptomatic relief for mitral regurgitation.
• The edge-to-edge technique demonstrates equal effectiveness in both FMR and DMR.
• While MR grade improves, sustained reverse remodeling of left ventricular dimensions was not observed.