![Large peridevice leaks after left atrial appendage occlusion (LAAO) are incredibly rare and not associated with a greater risk of adverse outcomes, according to new research published in JACC: Clinical Electrophysiology.[1] Smaller residual links are more common, however, and associated with a risk of thromboembolic and bleeding events.](/sites/default/files/styles/top_stories/public/2018-08/olderpatient-doctor.jpg.webp?itok=Cv18wcDr)
Patients with an elevated mitral valve gradient (MVG) after undergoing transcatheter edge-to-edge repair (TEER) with the MitraClip device experience outcomes similar to patients with an absent or lesser MVG, according to a new study published in JACC: Cardiovascular Interventions.
The study’s authors explored data from the renowned COAPT trial, which examined the safety and effectiveness of TEER—previously known as transcatheter mitral valve repair— after two years. All COAPT participants presented with heart failure and moderate-to-severe or severe functional mitral regurgitation (MR). They then either underwent TEER and guideline-directed medical therapy (GDMT) or GDMT alone.
Overall, the researchers found that patients with an elevated MVG—defined as anything larger than 5 mm Hg at discharge—had two-year rates of mortality and heart failure hospitalization that were comparable to the COAPT trial’s other patients. Outcomes were also similar when looking at New York Heart Association functional classes and other similar measures of heart functionality.
Elevated MVGs should still be “avoided if possible,” the authors added.
“This data is very reassuring for physicians who place MitraClips in patients with secondary mitral regurgitation,” co-author Howard C. Herrmann, MD, a professor of cardiovascular diseases at the University of Pennsylvania’s Perelman School of Medicine, said in a statement. “It demonstrates that the benefits of MR reduction in patients with heart failure were maintained even when mild-to-moderate mitral stenosis, which can be caused by a narrowing of the mitral valve, occurred after MitraClip.”
Additional studies are still needed, the team noted, to gain a better understanding of how TEER may impact heart failure patients with an elevated MVG who did not originally meet the COAPT trial’s eligibility criteria.
Abbott, the manufacturer behind MitraClip, sponsored the COAPT trial when it was first completed and has provided grant support to numerous authors behind this latest analysis.
Read the full study here.
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.