Why the study?
Mitral TEER decreases mitral valve area and can elevate mean gradient, but the clinical impact of elevated post-procedural gradient on outcomes is unclear.
Does elevated mitral gradient post transcatheter edge-to-edge repair worsen clinical outcomes in patients with severe mitral regurgitation?
Does elevated mitral gradient post transcatheter edge-to-edge repair worsen clinical outcomes in patients with severe mitral regurgitation?
Elevated mitral gradient following transcatheter edge-to-edge repair for severe mitral regurgitation is associated with worse clinical outcomes.
Elevated post-TEER mitral gradient warrants closer surveillance; meta-analysis confirms association with worse outcomes.
BACKGROUND: Mitral transcatheter edge-to-edge repair (TEER) is a minimally invasive therapy for severe mitral regurgitation (MR) in patients with high surgical risk. TEER results in a tissue bridge that decreases mitral valve area, potentially leading to elevated mean gradient. The clinical impact of elevated gradient on outcomes is unclear. METHODS: This systematic review and meta-analysis was based on a comprehensive search of five databases. We included studies that evaluated post mitral TEER gradient on one of the following outcomes: all-cause mortality, combined endpoints, symptoms, hospitalizations, and mitral valve re-intervention. Meta-analysis was conducted using the random-effects model. RESULTS: 62%) for all patients and for those with degenerative MR. CONCLUSION: Despite the heterogeneity between studies, the current analysis suggests that patients with elevated mitral gradient post TEER are at risk of worse clinical outcomes, particularly in patients who had mitral gradient assessed using discharge transthoracic echocardiogram.
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Alabdaljabar et al. (2024) studied this question.
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