Key result
Intraprocedural maximum vena contracta demonstrated excellent discriminatory power to identify significant mitral regurgitation persistence at 6 months (AUC 0.96; p < 0.001).
Why the study?
There is no consensus on the optimal intraprocedural parameter to evaluate residual mitral regurgitation after transcatheter edge-to-edge mitral repair.
Do intraprocedural TEE parameters predict the persistence of significant mitral regurgitation at 6 months follow-up in patients undergoing TEER?
Cohort (n=88)
No
Do intraprocedural TEE parameters predict the persistence of significant mitral regurgitation at 6 months follow-up in patients undergoing TEER?
Effect estimate: AUC 0.96
p-value: p=< 0.001
Intraprocedural maximum vena contracta >0.45 cm on TEE is a highly accurate predictor of significant residual mitral regurgitation at 6 months post-TEER.
May guide intraprocedural MR assessment post-TEER; leaves open which TEE parameter best predicts follow-up TTE grading.
Background: There is no consensus on the best intraprocedural parameter to evaluate residual mitral regurgitation (MR) after transcatheter edge-to-edge mitral repair (TEER). Thus, our aim was to evaluate the predictive value of different MR parameters from intraprocedural transesophageal echocardiogram (TEE) for grading in consecutive transthoracic echocardiogram (TTE) during the follow up. Methods: All the consecutive patients who underwent TEER with MitraClip between 2010 and 2020 in our center were considered. TEE-derived immediate postprocedural MR parameters were reassessed to blindly compare them with follow up MR grading in sequential TTE. Results: We finally included 88 patients (64.8% males; 76 ± 10 years-old). Significant MR was detected in 14.3% of the cases at 6 months, in similar proportion than at postprocedural at 1 month. Among all the intraprocedural TEE quantitative parameters only additive and maximum VC were associated with significant MR persistence. Moreover, on ROC analysis maximum VC demonstrated an excellent discriminatory power (AUC 0.96; p < 0.001) to identify MR ≥ III at 6 months. Thus, a cut-off point of 0.45 cm demonstrated 88% sensitivity and 89% specificity. Conclusion: Among intraprocedural TEE parameters to evaluate residual MR in TEER, maximum and additive VC were the most reliable to predict persistence of significant insufficiency.
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Pozo et al. (2022) conducted a cohort in Mitral regurgitation (n=88). Intraprocedural maximum vena contracta (VC) was evaluated on Significant mitral regurgitation persistence (MR ≥ III) at 6 months (AUC 0.96, p=< 0.001). Intraprocedural maximum vena contracta demonstrated excellent discriminatory power to identify significant mitral regurgitation persistence at 6 months (AUC 0.96; p < 0.001).
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