Characteristics and outcomes of patients screened for transcatheter mitral valve implantation: 1‐year results from the CHOICE‐MI registry
Why the study?
Transcatheter mitral valve implantation offers a novel option for mitral regurgitation patients unsuitable for established therapies, but outcomes of patients screened for TMVI needed investigation.
What are the 1-year outcomes of patients undergoing transcatheter mitral valve implantation (TMVI) compared to TMVI-ineligible patients receiving alternative therapies?
Population
746 patients with MR suboptimal for TEER and at high surgical risk across 26 centres
Comparison
TMVI vs bailout-TEER vs high-risk surgery vs medical therapy in TMVI-ineligible patients
Design
Multicentre registry
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
TMVI screening supports device feasibility with durable MR reduction in high-risk patients; leaves open optimal allocation versus alternatives pending randomized trials.
Structured PICO
What are the 1-year outcomes of patients undergoing transcatheter mitral valve implantation (TMVI) compared to TMVI-ineligible patients receiving alternative therapies?
P
Population
746 patients with mitral regurgitation (MR) considered suboptimal candidates for transcatheter edge-to-edge repair (TEER) and at high risk for mitral valve surgery, median age 78.5 years (IQR 72.0-83.0), EuroSCORE II 4.7% (IQR 2.7-9.7), screened at 26 centres.
I
Intervention
Transcatheter mitral valve implantation (TMVI) with 10 different dedicated devices
C
Comparator
TMVI-ineligible patients referred to bailout-TEER, high-risk surgery or medical therapy (MT)
O
Outcome
Composite of all-cause mortality or heart failure hospitalization after 1 yearcomposite
In patients with MR at high surgical risk and suboptimal for TEER, TMVI provides predictable MR elimination, while bailout-TEER and high-risk surgery are reasonable alternatives for TMVI-ineligible patients compared to medical therapy.
Cite This Study
Ali et al. (2022) studied this question.