Key result
In high-risk patients with mitral valve disease, 320-day all-cause mortality rates were comparable between those treated with self-expanding valves (26.7%) and balloon-expandable valves (20%).
Why the study?
TMVI with self-expanding or balloon-expandable valves is an emerging option for high-risk patients with symptomatic mitral valve disease, but clinical, procedural, and outcome parameters required evaluation.
Does transcatheter mitral valve implantation with self-expanding valves compared to balloon-expandable valves improve outcomes in high-risk patients with symptomatic mitral valve disease?
Observational (n=46)
No
Does transcatheter mitral valve implantation with self-expanding valves compared to balloon-expandable valves improve outcomes in high-risk patients with symptomatic mitral valve disease?
Absolute Event Rate: 26.7% vs 20%
p-value: p=0.60
TMVI with either self-expanding or balloon-expandable valves shows comparable mid-term mortality and acceptable hemodynamics in high-risk patients with mitral valve disease.
Comparable mortality in this small TMVI series; leaves open whether valve type affects outcomes in larger trials.
BACKGROUND: Transcatheter mitral valve implantation (TMVI) with self-expanding (SAV) or balloon-expandable (BAV) valves are rising as promising treatment options for high-risk patients with symptomatic mitral valve (MVD) disease unsuitable for alternative treatment options. AIMS: The aim of this study was to examine the clinical, procedural and outcome parameters of patients undergoing SAV or BAV for MVD. METHODS: In this observational and single-center case series, fifteen consecutive patients treated with the Tendyne Mitral Valve System (SAV) and thirty-one patients treated with SAPIEN prosthesis (BAV) were included. RESULTS: The patients (aged 78 years [interquartile range (IQR): 65.5 to 83.1 years], 41% women, EuroSCORE II 10.3% [IQR: 5.5 to 17.0%] were similar regarding baseline characteristics, despite a higher rate of prior heart valve surgery and prevalence of MV stenosis in the SAV-group. At discharge, the SAV-group had a mean transvalvular gradient of 4.2 mmHg, whereas the BAV-group had a mean transvalvular gradient of 6.2 mmHg. None or trace paravalvular leakage (PVL) was assessed in 85% in SAV-group and 80% in the BAV-group. 320 day all-cause and cardiac mortality rates were comparable in both groups (SAV: 26.7% vs BAV: 20%, p = 0.60). Four deaths occurred early in the SAV-group until 32 days of follow-up. CONCLUSIONS: In high-risk patients with MVD, TMVI presents a promising treatment option with encouraging mid-term outcomes and good valve durability. TMVI either with BAV or SAV may be developed to an established treatment option.
No takes yet. Share an insight, caveat, or question.
Wienemann et al. (2022) conducted an observational in Mitral valve disease (n=46). Transcatheter mitral valve implantation with self-expanding valve (SAV) vs. Transcatheter mitral valve implantation with balloon-expandable valve (BAV) was evaluated on 320-day all-cause mortality (p=0.60). In high-risk patients with mitral valve disease, 320-day all-cause mortality rates were comparable between those treated with self-expanding valves (26.7%) and balloon-expandable valves (20%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: