Valvular & structural heart disease
Association of Baseline Mitral Valve Area With Procedural and Clinical Outcomes of Mitral Transcatheter Edge-to-Edge Repair: Insights From the OCEAN-Mitral Registry
Authors' conclusion
In patients undergoing TEER, a small MVA <4.0 cm2 may limit the number of clips implanted and increase the transmitral pressure gradient after TEER, but baseline MVA was not associated with mitral regurgitation reduction and clinical outcomes.
Study context
- Population
- Patients undergoing mitral transcatheter edge-to-edge repair (TEER) with MitraClip for mitral regurgitation
- Participants
- 1,768 patients
- Exposure
- Baseline mitral valve area (MVA) <4.0 cm² vs 4.0-5.0 cm² vs ≥5.0 cm²
- Group 1n = 358
- Group 2n = 493reference
- Group 3n = 917reference
- Outcome
- Composite of:
- All-cause death
- HF hospitalization
- Follow-up
- Within 2 years of TEER
Methodological detailsOCEAN-Mitral registry
- OCEAN-Mitral registry
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
Group 1 vs Group 2
1.06(0.79–1.41)
P = 0.68Group 1 vs Group 3
0.99(0.75–1.31)
P = 0.96Observational data: associations, not effects.
Further findings
Number of clips implanted and postprocedural transmitral mean pressure gradient
- Smaller MVA: significantly fewer clips implanted and higher postprocedural transmitral mean pressure gradient
Acute procedural success and postprocedural MR severity
- No significant difference between the 3 groups
Primary end point, MVA <3.5 cm² vs 3.5 to 4.0 cm² (subgroup) · 2 years
- Similar in patients with MVA <3.5 cm² and those with MVA 3.5 to 4.0 cm²
Residual MR 3+/4+ · 1 year
- No significant difference between the 3 groups (7.2% versus 4.4% versus 6.5%)
- P = 0.49
Original publication
Association of Baseline Mitral Valve Area With Procedural and Clinical Outcomes of Mitral Transcatheter Edge-to-Edge Repair: Insights From the OCEAN-Mitral Registry. Circ Cardiovasc Interv. Published 17 December 2024. doi:10.
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