Project description:Mitral regurgitation (MR) is the most prevalent valvular heart disease and, when left untreated, results in reduced quality of life, heart failure, and increased mortality. Mitral valve transcatheter edge-to-edge repair (M-TEER) has matured considerably as a non-surgical treatment option since its commercial introduction in Europe in 2008. As a result of major device and interventional improvements, as well as the accumulation of experience by the interventional cardiologists, M-TEER has emerged as an important therapeutic strategy for patients with severe and symptomatic MR in the current European and American guidelines. Herein, we provide a comprehensive up-do-date overview of M-TEER. We define preprocedural patient evaluation and highlight key aspects for decision-making. We describe the currently available M-TEER systems and summarise the evidence for M-TEER in both primary mitral regurgitation (PMR) and secondary mitral regurgitation (SMR). In addition, we provide recommendations for device selection, intraprocedural imaging and guiding, M-TEER optimisation and management of recurrent MR. Finally, we provide information on major unsolved questions and "grey areas" in M-TEER.

| S-EPMC9869401 | biostudies-literature

Torrential Mitral Regurgitation After Transcatheter Edge-to-Edge Mitral Valve Repair.

Project description:A patient with severe mitral regurgitation and chronic systolic heart failure taking inotropic support at home presents for transcatheter edge-to-edge mitral valve repair, complicated by torrential mitral regurgitation from damaged mitral leaflets requiring escalating mechanical circulatory support and ultimately expedited orthotopic heart transplantation. (Level of Difficulty: Intermediate.).

| S-EPMC8305671 | biostudies-literature

Effect of Renal Impairment on Clinical Outcomes After Mitral Valve Transcatheter Edge-to-Edge Repair.

Project description:BackgroundRenal impairment is associated with poor clinical outcomes in patients with cardiovascular diseases. Some studies have revealed the impact of renal impairment on the clinical outcomes of patients who underwent mitral valve transcatheter edge-to-edge repair (M-TEER). However, limited data are available regarding the impact of baseline renal impairment after M-TEER in Asian-Pacific patients with heart failure and severe mitral regurgitation.ObjectivesThis study sought to examine the effect of renal impairment on clinical outcomes after M-TEER using a large-scale nationwide registry in Japan.MethodsA total of 2,150 patients enrolled in the OCEAN-Mitral (Optimized Catheter Valvular Intervention) registry were divided into 3 groups according to the estimated glomerular filtration rate (eGFR) before M-TEER: normal eGFR (≥60 mL/min/1.73 m2) (n = 291), renal impairment (<60 mL/min/1.73 m2) (n = 1,746), and dialysis (n = 113). The impact of renal impairment and dialysis on major adverse cardiovascular events (MACE) (a composite of all-cause death and hospitalization for heart failure) was examined.ResultsKaplan-Meier analysis revealed that the renal impairment and dialysis groups had a significantly higher incidence of MACE (survival rates at 2 years: normal eGFR, 74.2% [95% CI: 66.9%-80.1%] vs renal impairment, 63.9% [95% CI: 61.0%-66.6%] vs dialysis, 50.9% [95% CI: 38.2%-62.2%]; P < 0.001). Multivariate Cox regression analysis identified dialysis as the strongest independent predictor of MACE (HR: 1.95; 95% CI: 1.33-2.85; P < 0.001).ConclusionsRenal impairment was associated with an increased incidence of major adverse events, and dialysis was the strongest independent predictor of poor clinical outcomes after M-TEER in Asian-Pacific patients.

| S-EPMC11840231 | biostudies-literature

Mitral valve surgery after failed transcatheter edge-to-edge repair.

Project description:ObjectiveMitral valve operations for failed transcatheter edge-to-edge repair (TEER) are increasing. This study investigated the indications, surgical procedures, and outcomes after surgery for failed TEER.MethodsWe analyzed records of patients who underwent mitral valve operations after TEER between January 2013 and September 2021. Patient characteristics, clip number and location, indications, timing, surgery type, and outcomes were evaluated.ResultsA total of 41 patients (median age, 77 years; 14 women; median Society of Thoracic Surgeons predicted risk of mortality score, 9.4% [5.6%-12.6%]; and previous cardiac surgery in 21 patients) underwent mitral valve surgery at a median of 8 months (range, 4-16 months) after TEER. One clip was implanted in 24 patients and 2 or more in 17 patients. Indications for surgery were severe mitral regurgitation in 33, severe mitral stenosis in 1 patient, and both in 7 patients. Operations were performed via sternotomy in 37 patients and lateral thoracotomy in 4 patients. The mitral valve was replaced in all patients (bioprosthesis in 35 patients and a mechanical valve in 6 patients). Concomitant procedures were performed in 30 patients. Operative mortality was 5% (observed to expected ratio, 0.53) and did not differ for primary procedures versus reoperations. Echocardiographic follow-up demonstrated no or trivial mitral regurgitation in 34 patients, mild mitral regurgitation in 5 patients, and moderate perivalvular mitral regurgitation in 1 patient with severe mitral annular calcification. At a median follow-up of 1.5 years (interquartile range, 4.7 months-2.7 years), the actuarial survival was 79%.ConclusionsMitral valve replacement can be performed safely after failed TEER with operative mortality lower than expected even in high-risk patients.Video abstract

| S-EPMC9366625 | biostudies-literature

Rescue mitral transcatheter edge-to-edge repair followed by interval mitral valve replacement.

Project description: Not available

| S-EPMC10580101 | biostudies-literature

Transcatheter Edge-to-Edge Mitral Valve Repair versus Minimally Invasive Mitral Valve Surgery: An Observational Study

Project description: Not available

| S-EPMC10932335 | biostudies-literature

Successful transcatheter edge-to-edge repair of mitral valve leaflet perforation.

Project description: Not available

| S-EPMC11886805 | biostudies-literature

Right atrial thrombus during transcatheter edge-to-edge mitral valve repair.

Project description: Not available