Key result
TEER yields similar survival to surgery in high-risk degenerative MR but increases residual MR risk.
Why the study?
Data regarding transcatheter edge-to-edge repair (TEER) in treating high-risk surgical patients with degenerative mitral regurgitation (DMR) were scarce.
Does TEER reduce early all-cause mortality and improve 1-year survival compared to surgery in high-risk surgical patients with degenerative mitral regurgitation?
Meta-Analysis (n=935)
Yes
Does TEER reduce early all-cause mortality and improve 1-year survival compared to surgery in high-risk surgical patients with degenerative mitral regurgitation?
Effect estimate: OR 1.093 (95% CI 0.393-3.041)
Absolute Event Rate: 1.43% vs 1.86%
p-value: p=0.864
TEER offers similar early and 1-year survival to surgery in high-risk patients with degenerative mitral regurgitation, despite a higher rate of residual and recurrent MR.
Supports TEER as alternative for high-risk degenerative MR; confirms comparable survival versus surgery despite higher residual MR.
Abstract Background: Data regarding transcatheter edge-to-edge repair (TEER) in treating high-risk surgical patients with degenerative mitral regurgitation (DMR) is scarce. We performed a systematic review and meta-analysis to investigate the early outcomes of TEER for the treatment of DMR, as compared with surgery. Methods:PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials were systematically searched for eligible studies. The primary outcomes were early (in‐hospital or within 30 days) all-cause mortality and survival at 1-year. The secondary outcomes comprised acute postprocedural residual mitral regurgitation (MR) >2+, recurrent MR > 2+ at 1-year, and SF-36 physical score at 1-year. Results: A total of 4 studies were included in the meta-analysis. Pooled results showed that there was no significant difference in early all-cause mortality (OR = 1.093, 95% CI [0.393, 3.041], p = 0.864), survival at 1-year (OR= 0.996, 95% CI [0.403, 2.458], p = 0.993), and SF-36 physical score at 1-year (SMD = 0.044, 95% CI [-0.217, 0.305], p = 0.740) between TEER and surgery. However, TEER was associated a higher risk of acute postprocedural residual MR > 2+ (OR = 11.819, 95% CI [6.498, 21.496], p < 0.001) and MR >2+ at 1-year (OR = 4.114, 95% CI [2.188, 7.737], p <0.001) compared with surgery. Conclusions:TEER achieves similar early survival to surgery in DMR patients with high-risk profiles. Acute postprocedural residual MR >2+ and recurrent MR > 2+ at 1-year, however, occurs more frequently after TEER than surgery.
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Li et al. (2023) conducted a meta-analysis in Degenerative mitral regurgitation (n=935). Transcatheter edge-to-edge repair (TEER) vs. Surgery was evaluated on Early all-cause mortality (in-hospital or within 30 days) (OR 1.093, 95% CI 0.393-3.041, p=0.864). Transcatheter edge-to-edge repair achieved similar early all-cause mortality (OR 1.093) and 1-year survival compared to surgery in high-risk patients with degenerative mitral regurgitation, but had a higher risk of residual and recurrent MR.
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