The risk of in-hospital mortality may be significantly higher among transcatheter edge-to-edge repair (TEER) patients who present with concomitant hypertrophic cardiomyopathy (HC), according to new study of more than 23,000 patients. The full analysis was published in the American Journal of Cardiology.[1]
“Many patients with HC have concomitant mitral valve disease, with systolic anterior motion of the mitral valve apparatus and resultant mitral regurgitation,” wrote first author Agam Bansal, MD, with the department of internal medicine at Cleveland Clinic’s Heart and Vascular Institute, and colleagues. “These patients are often at an increased risk for progressive heart failure, supraventricular and ventricular arrhythmias, and sudden cardiac death.”
Bansal et al. noted that some prior studies have already explored the relationship between TEER—a procedure previously known as transcatheter mitral valve repair (TMVR)—and HC, but those assessments were “limited to case reports or series.”
“To better evaluate this issue, we thus used a large nationwide cohort to determine the outcomes of patients with a history of HC after TEER with MitraClip,” the authors wrote.
The group’s analysis focused on 22,914 adult patients who were underwent TEER with Abbott’s MitraClip device from 2014 to 2018. All data came from the Nationwide Readmission Database. A total of 122 patients, just 0.53% of the total cohort, presented with HC. These patients were younger and more likely to be female than patients without HC.
Overall, in-hospital mortality was 2.39% for patients without HC and 9.47% for patients with HC. Strokes were also much more common among patients with HC than those without HC, but the difference was not significant after making certain adjustments for baseline variables.
This “markedly increased” difference in in-hospital mortality stood out to the authors, who noted that previous research teams had not observed the same trend.
“In future, larger sample size prospective studies are needed to evaluate the utility of MitraClip in patients with HC and to compare its efficacy with alcohol septal ablation or septal myectomy,” Bansal et al. concluded.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.