Key result
In high-risk patients with symptomatic functional mitral regurgitation, conservative treatment was associated with a higher mortality hazard compared to MitraClip intervention (HR 1.79).
Why the study?
Treatment strategies for high-risk patients with mitral regurgitation differ by functional versus degenerative origin, motivating an evaluation of surgical, percutaneous, or conservative treatment according to valve mechanism.
Does percutaneous mitral valve repair (MitraClip) reduce mortality compared to surgical or conservative treatment in high-risk patients with functional or degenerative mitral regurgitation?
Cohort (n=963)
Yes
Does percutaneous mitral valve repair (MitraClip) reduce mortality compared to surgical or conservative treatment in high-risk patients with functional or degenerative mitral regurgitation?
Hazard Ratio: 1.79 (95% CI 1.34–2.39)
Absolute Event Rate: 33% vs 45%
p-value: p=<0.001
MitraClip intervention is associated with reduced mortality compared to conservative management in high-risk patients with symptomatic functional mitral regurgitation.
AIMS: Treatment strategies of high-risk patients with mitral regurgitation (MR) differ between disease based on functional and disease based on degenerative origin. In the present study, we aimed to evaluate the effect of surgical, percutaneous, or conservative treatment of MR according to MV mechanism, for high-risk patients. METHODS AND RESULTS: Survival outcomes of MitraClip, surgical, or conservative strategies were compared for 688 high-risk patients with functional MR and 275 with degenerative MR. Cox regression and propensity analyses were used to correct for differences in baseline characteristics. For functional MR, conservative treatment proved to have a higher mortality hazard when compared to MitraClip treatment (hazard ratio [HR] 1.79, 95% confidence interval [CI]: 1.34 to 2.39, p<0.001), while there was no significant difference in mortality hazard between MitraClip and surgery (HR 0.86, 95% CI: 0.54 to 1.38, p=0.541). For degenerative MR, no clear significant benefit was found when comparing MitraClip to conservative and surgical treatment. CONCLUSIONS: High-risk patients with symptomatic functional MR have reduced mortality when undergoing MitraClip intervention, compared to those receiving conservative treatment.
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Kortlandt et al. (2019) conducted a cohort in Symptomatic mitral regurgitation (functional or degenerative) (n=963). MitraClip vs. Conservative treatment was evaluated on All-cause mortality (HR 1.79, 95% CI 1.34-2.39, p=<0.001). In high-risk patients with symptomatic functional mitral regurgitation, conservative treatment was associated with a higher mortality hazard compared to MitraClip intervention (HR 1.79).
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