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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
PubMed

Insights

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.
Keywords:
hospitalizationmitral transcatheter edge-to-edge repairmortalitytranscatheter aortic valve replacement

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