Valvular & structural heart disease
Transapical Transcatheter Mitral Valve Replacement After Failed Transcatheter Edge-to-Edge Repair: A Multicenter Experience
Authors' conclusion
Transapical TMVR after ELASTA-Clip is a feasible and less invasive option for the management of failed M-TEER that can be performed with acceptable results in a carefully selected patient population.
Study context
- Population
- Symptomatic patients with failed mitral transcatheter edge-to-edge repair (M-TEER) (persistent or recurrent mitral regurgitation (MR), or iatrogenic mitral valve (MV) stenosis) at high surgical riskmedian follow-up 8.5 months
- Participants
- 22 patients
- Outcome
- Safety and efficacy per Mitral Valve Academic Research Consortium (MVARC) criteria
- Follow-up
- Up to 1 year
Methodological detailsmulticentre (8 tertiary care centers, 4 countries), single-arm
- Multicentre (8 tertiary care centers, 4 countries)
- Single-arm
Main finding
As reported in the abstract
Technical success (MVARC), without LV outflow tract obstruction or conversion to sternotomy
Technical success, 21/22 patients
95.4%
Observational data: associations, not effects.
Further findings
MR reduced to grade ≤1+ (baseline ≥3+ in 95.5% [21/22]), durable · median follow-up 8.5 months
- MR reduced to ≤1+ in all patients; durable results 17/19
- 89.5%
- P < 0.001
NYHA class improved to ≤II · discharge and last follow-up
- NYHA ≤II at discharge, 13/16 (P < 0.001)
- 81.3%
- NYHA ≤II at last follow-up, 13/18 (P < 0.001)
- 72.2%
Survival · 30 days
- All patients alive, 20/20
Safety
Ischemic stroke · 30 days
- Ischemic stroke, 3/20 patients
- 15.0%
Paravalvular leak progression · 30 days
- Patients with paravalvular leak progression
- 3
Rehospitalisation for HF
- Rehospitalised for HF, 3/20 patients (uncontrolled AF in 2 cases)
- 15.0%
Reintervention (valve retensioning)
- Reintervention, 1/22 patients
- 4.5%
Original publication
Transapical Transcatheter Mitral Valve Replacement After Failed Transcatheter Edge-to-Edge Repair: A Multicenter Experience. JACC Cardiovasc Interv. Published 10 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it