Temporal profiling of M-TEER-related complications
Jafer Haschemi1, Hanna Schrameck1, Jean Marc Haurand1
1Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
Aims:
Transcatheter edge-to-edge repair of the mitral valve (M-TEER) is known for its low complication rates. However, the optimal level and duration of post-procedural care remain unclear. This study aimed to identify the specific timeframe of post-procedural complications following M-TEER.
Methods And Results:
We conducted a retrospective analysis of 865 patients who underwent M-TEER at the University Hospital Düsseldorf between August 2010 and August 2023. Our analysis focused on a comprehensive examination of all acute post-procedural complications (1-100 h), considering the time point of occurrence or diagnosis. The complication analysed included cardiogenic shock, pericardial tamponade, stroke, cardiac arrhythmias, bleeding, acute kidney injury, myocardial infarction, peripheral vascular ischaemia and in-hospital mortality.
Results:
The median age was 80 (74, 84) years, and the EuroScore II was high (6.5 [4.0, 12.0] %). Functional mitral regurgitation (MR) was more common than degenerative or mixed MR (69% vs. 20%. respectively; 11%). Technical success rate was 97.2%. Overall, acute post-procedural complications occurred in 87 patients (10.1%). Most complications (75.9%) occurred within the first 4 h post-procedure. 12.6% of the complications occurred during the period between 4 and 24 h post-procedure, and 11.5% of the complications happened between 24 and 100 h post-procedure. Life-threatening complications were observed only within the first 4 h post-procedure.
Conclusions:
The majority of post-procedural complications after M-TEER occur within the first 4 h, with pericardial tamponade and major bleeding occurring only during this period. These findings provide valuable insight for physicians in determining the optimal surveillance and monitoring duration after M-TEER within clinical settings.
Insights
Most complications after transcatheter edge-to-edge repair of the mitral valve (M-TEER) occur within 4 hours post-procedure. Life-threatening events, including pericardial tamponade and major bleeding, were exclusively observed during this early period, guiding optimal patient monitoring.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Transcatheter edge-to-edge repair of the mitral valve (M-TEER) is a minimally invasive procedure for mitral regurgitation.
- While M-TEER has low complication rates, the optimal duration for post-procedural monitoring is not well-defined.
- Understanding the timing of potential complications is crucial for refining patient care protocols.
Purpose of the Study:
- To determine the specific time frame for acute post-procedural complications following M-TEER.
- To identify the types of complications and their occurrence patterns in the early post-procedural period.
Main Methods:
- Retrospective analysis of 865 patients undergoing M-TEER from August 2010 to August 2023.
- Detailed examination of acute complications (0-100 hours post-procedure), including cardiogenic shock, tamponade, stroke, arrhythmias, bleeding, AKI, MI, vascular ischemia, and mortality.
- Analysis focused on the time of complication occurrence or diagnosis.
Main Results:
- The majority of M-TEER patients (87/865, 10.1%) experienced acute post-procedural complications.
- Most complications (75.9%) occurred within the first 4 hours post-procedure.
- Life-threatening complications, such as pericardial tamponade and major bleeding, were exclusively observed within the initial 4-hour window.
Conclusions:
- The critical period for acute complications after M-TEER is the first 4 hours post-procedure.
- This early timeframe is particularly important for severe events like pericardial tamponade and major bleeding.
- Findings support focused surveillance and monitoring during the initial 4 hours post-M-TEER to optimize patient safety.
