M-TEER still beneficial for high-risk patients with smaller mitral valve areas
Mitral valve transcatheter edge-to-edge repair (M-TEER) is safe and effective in patients with a smaller mitral valve area (MVA), according to a new two-year analysis published in Structural Heart.[1]
The study’s authors noted that M-TEER is typically reserved for patients with a baseline MVA > 4 cm² to limit the risk of iatrogenic mitral stenosis. However, patients with a smaller MVA do sometimes present with severe symptomatic mitral regurgitation (MR) and no other alternative treatment options. In those cases, despite the risk of iatrogenic mitral stenosis, the care team may determine that M-TEER represents the best course of action.
To learn more about the long-term impact of treating these patients, researchers tracked data from more than 350 consecutive M-TEER patients treated at a high-volume hospital from 2014 to 2022. All patients were treated with the MitraClip system manufactured by Abbott. Approximately 22% of those patients had a baseline MVA < 4 cm².
Mean ages and baseline comorbidities were comparable for patients with larger and smaller MVAs. However, patients with smaller MVAs were still still associated with significantly higher Society of Thoracic Surgeons Predicted Risk of Mortality scores for both mitral valve repair and mitral valve replacement.
Overall, the in-hospital mortality rate was 0% for both groups. In addition, post-procedural complications were rare and comparable in both groups. Patients with a smaller MVA did tend to have a higher transmitral pressure gradient (TMPG) at discharge, but the difference was not statistically significant or correlate in worse patient outcomes.
Even after two years, the authors added, there were no statistically significant differences in patient outcomes or echocardiographic findings for these two groups.
“Importantly, our data reinforce that M-TEER is not only feasible but also safe and effective in patients with small MVAs, particularly in high-surgical-risk populations,” wrote first author Chloé Kharsa, MD, MSc, a researcher with Houston Methodist DeBakey Heart and Vascular Center, and colleagues. “Surgical mitral valve repair or replacement in the setting of small annuli or extensive mitral annular calcification is technically complex and has been associated with increased morbidity and mortality. In contrast, M-TEER offers a viable alternative, especially when performed in experienced high-volume centers.”
Read the full analysis here.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.