Valvular & structural heart diseaseCohort study
Long-Term Clinical and Hemodynamic Outcomes of Transcatheter Mitral Valve Replacement
- Single-centre cohort study
Authors' conclusion
TMVR with balloon-expandable aortic prostheses provides favorable long-term outcomes and acceptable durability, with low rates of severe SVD and valve failure.
Study context
- Population
- All patients undergoing transcatheter mitral valve replacement (TMVR) with balloon-expandable transcatheter heart valves, usually trans-septal
- Participants
- 200 patients
- Exposure
- Valve-in-valve vs Valve-in-ring vs Valve-in-mitral annular calcification
- Valve-in-valven = 121reference
- Valve-in-ringn = 45
- Valve-in-mitral annular calcificationn = 34
- Outcome
- Death or mitral reintervention (surgical or transcatheter replacement or transplantation)
Main finding
As reported in the abstract
Freedom from death or reintervention at 1 year
82% (95% CI 77%-88%)
Freedom from death or reintervention at 5 years
48% (95% CI 40%-56%)
Freedom from death or reintervention at 8 years
20% (95% CI 11%-29%)
Worse outcomes in valve-in-ring and valve-in-mitral annular calcification vs valve-in-valve
P < 0.01
Observational data: associations, not effects.
Secondary outcomes
Mean gradient change
- Slight increase over time, mm Hg/y (P < 0.01)
- +0.25 ± 0.07
Effective orifice area change
- Modest decrease, cm²/y (P < 0.01)
- −0.04
Significant recurrent mitral regurgitation
- 11 of 200
- 5.5%
Severe structural valve deterioration (SVD) · after 5.3 (Q1-Q3: 3.5-7.4 years)
- 14 of 200
- 7%
TMVR failure · after 4.4 (Q1-Q3: 1.8-6.7 years)
- 20 of 200
- 10%
Original publication
Summarised from the published abstract; every number is checked against it