Outcomes of Transcatheter Edge-to-Edge Repair in Degenerative vs. Functional Mitral Regurgitation

Mark Kheifets*, Filippo Angelini, Fabrizio D’Ascenzo, Stefano Pidello, Haya Engelstein, Pier Paolo Bocchino, Paolo Boretto, Simone Frea, Amos Levi, Hana Vaknin-Assa, Mordehay Vaturi, Yaron Shapira, Ran Kornowski, Leor Perl

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Current guidelines support the use of transcatheter edge-to-edge repair (TEER) for patients with both primary and secondary mitral regurgitation. We aimed to compare the prognoses of TEER in degenerative mitral regurgitation (DMR) vs. functional mitral regurgitation (FMR). A total of 208 consecutive patients who underwent TEER over a ten-year period were analyzed. Primary endpoints included rates of all-cause death and major adverse cardiac events (MACE: composite of all-cause death, hospitalizations for heart failure, mitral valve surgery, or TEER re-intervention). A total of 148 (71%) patients were identified with FMR, while 60 (29%) were identified with DMR. Patients in the FMR group were younger (77.2 ± 8.4 vs. 80.2 ± 7.2, p = 0.02), suffered more frequently from coronary artery disease (54.1% vs. 10.0%, p = 0.02), and atrial fibrillation/flutter (70.9% vs. 38.3%, p = 0.02). Rates of 1-year death (21.6% vs. 10.0%, p = 0.03) and MACE (41.2% vs. 21.7%, p = 0.02) were higher for the FMR group, as compared to the DMR group. After correcting for variables, FMR independently predicted rates of MACE (HR-1.78, 95% CI 1.23–2.48, p = 0.04) and had a non-significant effect on one-year mortality (HR-1.67, 95%CI 0.98–3.74, p = 0.07). In our experience, worse overall 1-year composite MACE outcomes were observed after TEER in patients with FMR as compared to patients with DMR.

Original languageEnglish
Article number6010
JournalJournal of Clinical Medicine
Volume11
Issue number20
DOIs
StatePublished - Oct 2022

Keywords

  • degenerative mitral regurgitation (DMR)
  • functional mitral regurgitation (FMR)
  • transcatheter edge-to-edge repair (TEER)

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