Valvular & structural heart diseaseCohort study
Surgical Mitral Valve Repair vs Replacement After Failed Mitral Transcatheter Edge-to-Edge Repair
- Retrospective registry study
- multicentre
- 34 centres
Authors' conclusion
MV surgery after failed M-TEER is a high-risk procedure associated with higher than expected 30-day mortality, with higher mortality associated with MV replacement. Compared with repair, replacement is associated with higher 1-year mortality and a lower 2-year survival.
Study context
- Population
- Patients undergoing mitral valve (MV) surgery after failed mitral transcatheter edge-to-edge repair (CUTTING-EDGE registry, 2009–2020)
- Participants
- 332 patients · 34 centres
- Exposure
- Surgical MV repair vs replacement after failed mitral transcatheter edge-to-edge repair (M-TEER)
- Repairn = 25reference
- Replacementn = 307
- Outcome
- 30-day mortality and 1-year survival after MV surgery
- Follow-up
- 30 days; 1 year
Main finding
As reported in the abstract
30-day mortality and 1-year mortality after MV surgery
- Replacement vs Repair: P = 0.094
- Replacement vs Repair: P = 0.041
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Survival at 2 years · risk-adjusted Cox regression | 4.24 (1.04–17.31) | P = 0.044 | |
| 0.050.21520Hazard ratio (log scale) |
Observed-to-expected ratio
| Outcome | Repair | Replacement | Estimate | P value |
|---|---|---|---|---|
| Observed-to-expected ratio of 30-day mortality | 1.7 (95% CI 0.7–3.3) | 3.8 (95% CI 2.1–5.5) | ||
| Survival at 2 years · lower survival after replacement | P = 0.033 |
- Observed-to-expected ratio of 30-day mortality — Overall observed-to-expected ratio
- 3.6 (95% CI: 1.9-5.3)
Original publication
Surgical Mitral Valve Repair vs Replacement After Failed Mitral Transcatheter Edge-to-Edge Repair. JACC Cardiovasc Interv. Published 14 April 2025. doi:10.1016/j.jcin.2025.02.008
Summarised from the published abstract; every number is checked against it