Key result
Bicommissural MR is linked to ~695% higher odds of suboptimal residual MR after TEER.
Why the study?
Residual mitral regurgitation after TEER is associated with worse outcomes, prompting identification of echocardiographic predictors of suboptimal residual MR in secondary MR.
Cohort (n=65)
No
Preprocedural echocardiographic features, including bicommissural MR, larger annular diameter, and a smaller MVA to LVEDV ratio, are associated with suboptimal residual MR following TEER in patients with secondary MR.
May inform TEER patient selection in secondary MR; hypothesis-generating and requires prospective validation.
Background: Residual mitral regurgitation (MR) following mitral valve transcatheter edge-to-edge repair (TEER) is associated with worse outcomes. This study sought to identify echocardiographic predictors of suboptimal residual MR after TEER in patients with secondary MR. Methods: In this retrospective single-center study, we identified all patients with secondary MR who underwent TEER between 2016 and 2021. Pre- and intraprocedural transesophageal echocardiographic images were reviewed. The primary outcome was suboptimal residual MR, defined as ≥2+ residual MR on postprocedural transesophageal echocardiography. The association of preprocedural echocardiographic parameters with the primary outcome was tested via logistic regression. Conclusions: Certain echocardiographic features, including bicommissural MR, a larger annular diameter, and a smaller ratio of mitral valve area to left ventricular end-diastolic volume, are associated with suboptimal residual MR following TEER. These preprocedural measurements may optimize patient selection in those with secondary MR being considered for TEER.
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Labin et al. (2022) conducted a cohort in Secondary mitral regurgitation (n=65). Transcatheter edge-to-edge repair (TEER) with MitraClip was evaluated on Suboptimal residual mitral regurgitation (≥2+ MR on post-procedural transesophageal echocardiography) (OR 7.95, 95% CI 1.50-42.3, p=0.02). Bicommissural mitral regurgitation (OR 7.95), larger anteroposterior diameter, and smaller mitral valve area to left ventricular end-diastolic volume ratio predicted suboptimal residual MR after TEER.
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