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Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair

2021; Elsevier BV; Volume: 14; Issue: 18 Linguagem: Inglês

10.1016/j.jcin.2021.07.029

1936-8798

Tsuyoshi Kaneko, Sameer Hirji, Syed Zaid, Rüdiger Lange, Jörg Kempfert, Lenard Conradi, Christian Hagl, Michael A. Borger, Maurizio Taramasso, Tom C. Nguyen, Gorav Ailawadi, Ashish S. Shah, Robert L. Smith, Amédéo Anselmi, Matthew A. Romano, Walid Ben Ali, Basel Ramlawi, Kendra J. Grubb, N. Bryce Robinson, Luigi Pirelli, Michael Chu, Martin Andreas, Jean‐François Obadia, Marco Gennari, Andrea Garatti, Didier Tchetché, Tamim Nazif, Vinayak Bapat, Thomas Modine, Paolo Denti, Gilbert H.L. Tang, Keti Vitanova, Markus Krane, Serdar Akansel, Oliver D. Bhadra, Shekhar Saha, Erik Bagaev, Thilo Noack, Florian Fahr, Guido Ascione, Ana Paula Tagliari, Alejandro Pizano, Marissa Donatelle, Kashish Goel, John J. Squiers, Pinak Shah, Guillaume Leurent, Hervé Corbineau, Anita Asgar, Philippe Demers, Michel Pellerin, Denis Bouchard, Chawannuch Ruaengsri, Lin Wang, George Petrossian, Chad Kliger, Lionel Leroux, Muhanad Algadheeb, Shahar Lavi, Paul Werner, Michele Flagiello, Antonio L. Bartorelli, Angie Ghattas, Nicholas Dumonteil, Moritz Wyler von Ballmoos, Marvin D. Atkins, Augusto D’Onofrio, Chiara Tessari, Arnar Geirsson, Ryan Kaple, Francesco Massi, Michele Triggiani, Eric Van Belle, Flavien Vincent, Tom Denimal, Christina Brinkmann, Joachim Schöfer, Marco Di Eusanio, Filippo Capestro, Rodrigo Estévez‐Loureiro, Miguel Piñón, Neal S. Kleiman, Michael J. Reardon, Molly Szerlip, J. Michael DiMaio, Michael J. Mack, D. Scott Lim, Volkmar Falk, Francesco Maisano, Isaac George, Rebecca T. Hahn,

Cardiovascular Function and Risk Factors

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).Although >100,000 mitral TEER procedures have been performed worldwide, longitudinal data on MV surgery after TEER are lacking.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.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 interval 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.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.