Small Mitral Valve Orifice Area in Mitral Valve Transcatheter Edge-to-Edge Repair: The REPAIR Study

Figures

• 

  Central Illustration. PASCAL M-TEER for Small 3D-MVOA: The REPAIR Study Patients undergoing M-TEER were stratified according to baseline 3D-MVOA. Of the 1,189 patients, 28% were treated with 3D-MVOA <4 cm2 and 72% with 3D-MVOA ≥4 cm2. MVARC-defined technical success (95.9% vs 98.2%; P = 0.028), MR reduction to MR ≤1+ (71.7% vs 71.8%; P > 0.999), NYHA functional class reduction by ≥I class to 30 days (60.6% vs 63.6%; P = 0.532), 1-year all-cause mortality (13.0% vs 13.6%; P = 0.760), and a multivariable Cox model for 1-year all-cause mortality (HR 1.05, 95% CI: 0.67-1.63, P = 0.842) are shown for patients with 3D-MVOA <4 compared to ≥4 cm2, respectively. 3D = 3-dimensional; LVEF = left ventricular ejection fraction; MMR = mixed MR; MR = mitral regurgitation; M-TEER = mitral valve transcatheter edge-to-edge repair; MVOA = mitral valve orifice area; PMR = primary MR; SMR = secondary MR.

• 

  Figure 4. 1-Year Mitral Valve Reintervention Rate According to Baseline 3D-MVOA Kaplan-Meier curve illustrating the 1-year reintervention rate according to baseline 3D-MVOA. The 1-year mitral valve reintervention rate was 2.9% (95% CI: 0.5%-5.2%) in patients with baseline 3D-MVOA <4 cm2 and 2.9% (95% CI: 1.5%-4.3%) in patients with 3D-MVOA ≥4 cm2. Abbreviations as in Figure 1.

• 

  Figure 1. Paired MR Grade from Baseline to Latest Follow-Up Paired MR grade is depicted for (A) patients with 3D-MVOA <4 cm2 and (B) ≥4 cm2 with available echocardiographic assessments at baseline, discharge, and latest follow-up. Values < 1% are not displayed in the figure. In patients with 3D-MVOA <4 cm2 (A), 1 patient (0.7%, 1/138) had MR 2+ at baseline, 1 patient (0.7%, 1/138) had MR 4+ at discharge, and one patient (0.7%, 1/138) had MR 4+ at latest available echocardiographic follow-up. In patients with 3D-MVOA ≥4 cm2 (B), 1 patient (0.3%, 1/396) had MR 4+ at discharge. No difference was observed in the rate of MR ≤ 1+ at latest available echocardiographic follow-up (P = 0.698). 3D = three-dimensional; MR = mitral regurgitation; MVOA = mitral valve orifice area.

• 

  Figure 2. 1-Year All-Cause Mortality According to Baseline 3D-MVOA Kaplan-Meier curve showing 1-year all-cause mortality according to baseline 3D-MVOA. One-year all-cause mortality was 13.0% (95% CI: 8.5%-17.4%) in patients with 3D-MVOA <4 cm2 and 13.6% (95% CI: 10.9%-16.3%) in those with 3D-MVOA ≥4 cm2 (P = 0.760). 3D = three-dimensional; MVOA = mitral valve orifice area.

• 

  Figure 3. 1-Year All-Cause Mortality or First Heart Failure Hospitalization According to Baseline 3D-MVOA Kaplan-Meier curve depicting 1-year all-cause mortality or heart failure hospitalization according to baseline 3D-MVOA. One-year all-cause mortality or first hospitalization for HF rates were 22.3% (95% CI: 16.6%-27.6%) in patients with baseline 3D-MVOA <4 cm2 and 21.8% (95% CI: 18.4%-25.0%) in those with 3D-MVOA ≥4 cm2 (P = 0.984). HF = heart failure; other abbreviations as in Figure 1.