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Investigation of outcomes following transcatheter edge to edge repair of the mitral valve versus medical management alone in patients with cardiogenic shock and mitral regurgitation
Journal article   Open access   Peer reviewed

Investigation of outcomes following transcatheter edge to edge repair of the mitral valve versus medical management alone in patients with cardiogenic shock and mitral regurgitation

Caleb J. Chiang, Mina Kerolos, Michael Sunnaa, Sushant Koirala, Joseph Eid, Ethan M. Ritz, Laith A. Derbas, Fareed Moses Collado, Tisha M. Suboc, Clifford J. Kavinsky, …
American heart journal plus, Vol.45, pp.100430-100430
09/01/2024
DOI: 10.1016/j.ahjo.2024.100430
PMID: 39184147
url
https://doi.org/10.1016/j.ahjo.2024.100430View
Published (Version of record) Open Access

Abstract

Study objective: Assessing if Transcatheter Edge to Edge Repair (TEER) with MitraclipTM in patients with moderate to severe mitral regurgitation (MR) and cardiogenic shock (CS) improves outcomes compared to medical management alone. Design: A single-center, retrospective study was performed in an urban tertiary referral center. Setting: Rush University Medical Center, United States. Participants: Adult patients presenting with CS and moderate to severe MR between 2012 and 2021 were included. Interventions: Undergoing Mitral TEER with Mitraclip versus medical management alone. Main outcome measures: Major adverse cardiovascular events (MACE) defined as cardiovascular death, heart failure admission, stroke, and myocardial infarction assessed at 30 days, 6 months, and 1 year. The secondary outcome was a change in New York Heart Association (NYHA) classification at 30 days and 6 months. Results: There were 28 patients included in the medical management and 33 in the mitral valve TEER groups. There was a decreased MACE in the intervention group at 30 days (24.2 % vs. 46.4 %, p <= 0.001) and 6 months (27 % vs. 75 %, p = 0.002), though not at 1 year (29.4 % vs. 41.7 %, p = 0.42). At 30 days, more patients in the mitral valve TEER group improved to NYHA classes I/II compared to medical management alone (10 [35.7 %] vs. 16 [50 %], p = 0.043). There were no differences in NYHA classes I/II at 6 months (7 [43.7 %] vs. 13 [54.2 %], p = 0.63). Conclusion: Mitral valve TEER using the MitraclipTM system improves mid-term cardiovascular compared to medical management alone in patients with CS but does not improve mortality.
 Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology

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