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Mitral Valve Transcatheter Edge-to-Edge Repair After TAVR: A Nationwide Analysis
Ahmed Elkaryoni1, Marwan Saad1, Amir Darki2
1Division of Cardiovascular Disease, Lifespan Cardiovascular Institute, Providence, Rhode Island; Division of Cardiovascular Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
The American Journal of Cardiology
|October 20, 2023
Summary
Mitral transcatheter edge-to-edge repair (M-TEER) after transcatheter aortic valve replacement (TAVR) is increasing. While M-TEER post-TAVR shows similar mortality, it has higher 30-day hospitalizations but reduced 90-day rates.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Persistent severe mitral regurgitation (MR) post-transcatheter aortic valve replacement (TAVR) poses a clinical challenge.
- Mitral transcatheter edge-to-edge repair (M-TEER) is an emerging option for managing post-TAVR MR.
Purpose of the Study:
- To evaluate the outcomes of M-TEER in patients with prior TAVR compared to those without.
- To analyze trends in M-TEER procedures performed after TAVR.
Main Methods:
- Retrospective analysis of the Nationwide Readmission Database (2014-2020).
- Comparison of in-hospital mortality and 30/90-day rehospitalization rates between M-TEER post-TAVR and M-TEER without prior TAVR.
- Analysis restricted to the latter half of each calendar year due to data limitations.
Main Results:
- The incidence of M-TEER post-TAVR increased significantly from 2014 to 2020.
- Patients undergoing M-TEER post-TAVR had similar in-hospital mortality but higher 30-day all-cause and heart failure hospitalizations compared to controls.
- However, M-TEER significantly reduced cumulative 90-day all-cause and heart failure hospitalization rates in the post-TAVR cohort.
Conclusions:
- M-TEER is increasingly utilized for severe MR following TAVR.
- While short-term rehospitalization rates are higher, M-TEER offers significant long-term benefits in reducing hospitalizations for patients with prior TAVR.
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