Journal article
Transcatheter versus Surgical Mitral Valve Repair in Patients with Mitral Regurgitation
European journal of cardio-thoracic surgery, Vol.65(1), ezad391
01/02/2024
DOI: 10.1093/ejcts/ezad391
Abstract
OBJECTIVES To compare clinical outcomes of transcatheter and surgical mitral valve repair in primary mitral regurgitation and mitral regurgitation with heart failure with reduced ejection fraction. METHODS In this retrospective cohort study, we used Nationwide Readmission Database to identify primary mitral regurgitation and mitral regurgitation with heart failure with reduced ejection fraction patients who underwent transcatheter or surgical mitral valve repair from 2016 to 2019. A propensity score with 1:1 matching was applied. Primary outcome was a cumulative event rate of major adverse cardiovascular events, which is a composite of all-cause mortality, myocardial infarction, stroke, heart failure, cardiac arrest, and mitral valve replacement. Other important secondary outcome is inhospital mortality. RESULTS After propensity-score matching, 2187 matched-pairs were found in the primary mitral regurgitation cohort and 2178 matched-pairs were found in the mitral regurgitation-heart failure with reduced ejection fraction cohort. Transcatheter mitral valve repair had significantly higher medium-term major adverse cardiovascular events compared with surgical mitral valve repair in both cohorts [primary mitral regurgitation: hazard ratio: 1.73, 95% CI: 1.33-2.26, p = <0.001; mitral regurgitation-heart failure with reduced ejection fraction: hazard ratio: 2.00, 95% CI: 1.58-2.54, p = <0.001]. Transcatheter mitral valve repair was associated with a higher risk of mortality, readmissions for heart failure, and mitral valve replacement but a similar risk of stroke, atrial fibrillation/flutter, and myocardial infarction compared with surgical mitral valve repair in both cohorts. Transcatheter mitral valve repair showed similar in-hospital mortality and lower in-hospital morbidity than surgical mitral valve repair. CONCLUSIONS Although Transcatheter mitral valve repair showed better short-term outcomes, it had significantly higher medium-term major adverse cardiovascular events than surgical mitral valve repair in both cohorts. Thus, shared decision-making should be done for transcatheter mitral valve repair after discussing the benefits and risks in patients who can undergo surgical mitral valve repair.
Details
- Title: Subtitle
- Transcatheter versus Surgical Mitral Valve Repair in Patients with Mitral Regurgitation
- Creators
- Monil Majmundar - University of Kansas Medical CenterKunal Nitinkumar Patel - West Virginia UniversityRajkumar Doshi - St. Joseph’s University Medical CenterAshish Kumar - Akron General Medical CenterShilpkumar AroraSidakpal Panaich - University of Iowa, Cardiovascular MedicineAnkur Kalra - Franciscan Health
- Resource Type
- Journal article
- Publication Details
- European journal of cardio-thoracic surgery, Vol.65(1), ezad391
- DOI
- 10.1093/ejcts/ezad391
- eISSN
- 1873-734X
- Grant note
- name: makeadent.org Ram and Sanjita Kalra Aavishqaar
- Language
- English
- Electronic publication date
- 11/24/2023
- Date published
- 01/02/2024
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984517658602771
Metrics
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