Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair Mid-Term Outcomes From the CUTTING-EDGE International Registry

Kaneko, Tsuyoshi; Hirji, Sameer; Zaid, Syed; Lange, Rudiger; Kempfert, Jorg; Conradi, Lenard; Hagl, Christian; Borger, A. Michael; Taramasso, Maurizio; Nguyen, C. Tom; Ailawadi, Gorav; Shah, S. Ashish; Smith, L. Robert; Anselmi, Amedeo; Romano, A. Matthew; Ben Ali, Walid; Ramlawi, Basel; Grubb, J. Kendra; Robinson, B. Newell; Pirelli, Luigi; Chu, W. A. Michael; Andrea, Martin; Obadia, Jean-Francois; Gennari, Marco; Garatti, Andrea; Tchetche, Didier; Nazif, M. Tamim; Bapat, N. Vinayak; Modine, Thomas; Denti, Paolo und Tang, H. L. Gilbert (2021): Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair Mid-Term Outcomes From the CUTTING-EDGE International Registry. In: Jacc-Cardiovascular Interventions, Bd. 14, Nr. 18: S. 2010-2021

Abstract

OBJECTIVES The aim of this study was to determine clinical and echocardiographic characteristics, mechanisms of failure, and outcomes of mitral valve (MV) surgery after transcatheter edge-to-edge repair (TEER). BACKGROUND Although >100,000 mitral TEER procedures have been performed worldwide, longitudinal data on MV surgery after TEER are lacking. METHODS Data from the multicenter, international CUTTING-EDGE registry were retrospectively analyzed. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 9.0 months (interquartile range [IQR]: 1.2-25.7 months) after MV surgery, and follow-up was 96.1% complete at 30 days and 81.1% complete at 1 year. RESULTS From July 2009 to July 2020, 332 patients across 34 centers underwent MV surgery after TEER. The mean age was 73.8 +/- 10.1 years, median Society of Thoracic Surgeons risk for MV repair at initial TEER was 4.0 (IQR: 2.3-7.3), and primary/mixed and secondary mitral regurgitation were present in 59.0% and 38.5%, respectively. The median in-terval from TEER to surgery was 3.5 months (IQR: 0.5-11.9 months), with overall median Society of Thoracic Surgeons risk of 4.8% for MV replacement (IQR: 2.8%-8.4%). The primary indication for surgery was recurrent mitral regurgitation (33.5%), and MV replacement and concomitant tricuspid surgery were performed in 92.5% and 42.2% of patients, respectively. The 30-day and 1-year mortality rates were 16.6% and 31.3%, respectively. On Kaplan-Meier analysis, the actuarial estimates of mortality were 24.1% at 1 year and 31.7% at 3 years after MV surgery. CONCLUSIONS In this first report of the CUTTING-EDGE registry, the mortality and morbidity risks of MV surgery after TEER were not negligible, and only <10% of patients underwent MV repair. These registry data provide valuable insights for further research to improve these outcomes. (J Am Coll Cardiol Intv 2021;14:2010-2021) (c) 2021 by the American College of Cardiology Foundation.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1936-8798
• Sprache: Englisch