Impact of Mitral Regurgitation Etiology on Mitral Surgery After Transcatheter Edge-to-Edge Repair

doi:10.1016/j.jcin.2023.02.029

Cohort study

Impact of Mitral Regurgitation Etiology on Mitral Surgery After Transcatheter Edge-to-Edge Repair

JACC Cardiovasc IntervPublished 22 May 2023

Retrospective registry analysis
CUTTING-EDGE registry

Median follow-up 9.1 months (IQR: 1.1-25.8 months) after surgery

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Authors' conclusion

The risk of MV surgery after TEER is nontrivial, with higher mortality after surgery, especially in SMR patients.

Study context

Population: Patients undergoing mitral valve (MV) surgery after failed transcatheter edge-to-edge repair (TEER), July 2009–July 202047% primary (PMR), 53.0% SMR
Participants: 330 patients

Exposure: SMR vs PMR in MV surgery after failed TEER
Outcome: MVARC outcomes
Follow-up: 30 days and 1 year

Main finding

As reported in the abstract

Mortality

30-day mortality

P = 0.072

PMR12.7%

SMR20.4%

1-year mortality

P = 0.019

PMR23.2%

SMR38.3%

Outcome	PMR	SMR	P value
30-day observed-to-expected mortality ratio	2.6 (95% CI: 1.2-4.0)	4.6 (95% CI: 2.6-6.6)

30-day observed-to-expected mortality ratio, overall: 3.6 (95% CI: 1.9-5.3)

Observational data: associations, not effects.

Further findings

Aborted TEER, surgery for mitral stenosis after TEER, MV repair

Aborted TEER

P = 0.043

PMR16.3%

SMR25.7%

Surgery for mitral stenosis

P = 0.008

PMR9.0%

SMR19.4%

MV repair

P = 0.019

PMR11.0%

SMR4.0%

Original publication

Impact of Mitral Regurgitation Etiology on Mitral Surgery After Transcatheter Edge-to-Edge Repair. JACC Cardiovasc Interv. Published 22 May 2023. doi:10.1016/j.jcin.2023.02.029

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Summarised from the published abstract; every number is checked against it