October 10, 2023Journal of the American Heart Association48 citationsOpen Access
One‐Year Outcomes and Their Relationship to Residual Mitral Regurgitation After Transcatheter Edge‐to‐Edge Repair With MitraClip Device: Insights From the OCEAN‐Mitral Registry
Structured PICO
Does residual mitral regurgitation severity (≥2+) after transcatheter edge-to-edge repair increase the risk of death or heart failure hospitalization at 1 year compared to MR 0+/1+?
P
Population
2,150 patients undergoing transcatheter edge-to-edge repair (primary cause of MR 34.6%) from the Asian-Pacific OCEAN-Mitral registry.
I
Intervention
Transcatheter edge-to-edge repair (TEER) with MitraClip device
C
Comparator
Residual mitral regurgitation 0+/1+ at discharge
O
Outcome
Composite of death or heart failure hospitalization at 1 yearcomposite
Residual mitral regurgitation of 2+ or greater after transcatheter edge-to-edge repair is associated with significantly worse 1-year clinical outcomes compared to MR 0+/1+.
Abstract
Background Limited data are available about clinical outcomes and residual mitral regurgitation (MR) after transcatheter edge-to-edge repair in the large Asian-Pacific cohort. Methods and Results From the Optimized Catheter Valvular Intervention (OCEAN-Mitral) registry, a total of 2150 patients (primary cause of 34.6%) undergoing transcatheter edge-to-edge repair were analyzed and classified into 3 groups according to the residual MR severity at discharge: MR 0+/1+, 2+, and 3+/4+. The mortality and heart failure hospitalization rates at 1 year were 12.3% and 15.0%, respectively. Both MR and symptomatic improvement were sustained at 1 year with MR ≤2+ in 94.1% of patients and New York Heart Association functional class I/II in 95.0% of patients. Compared with residual MR 0+/1+ (20.4%) at discharge, both residual MR 2+ (30.2%; P P = 0.007) were associated with the higher incidence of death or heart failure hospitalization (adjusted hazard ratio HR, 1.59; P P = 0.008). New York Heart Association class III/IV at 1 year was more common in the MR 3+/4+ group (20.0%) than in the MR 0+/1+ (4.6%; P P P = 0.02). Conclusions The OCEAN-Mitral registry demonstrated favorable clinical outcomes and sustained MR reduction at 1 year in patients undergoing transcatheter edge-to-edge repair. Both residual MR 2+ and 3+/4+ after transcatheter edge-to-edge repair at discharge were associated with worse clinical outcomes compared with residual MR 0+/1+. Registration Information https://upload.umin.ac.jp. Identifier: UMIN000023653.