Key result
Transcatheter mitral valve-in-valve and valve-in-ring procedures demonstrated 30-day pooled all-cause mortality of 7% and 8%, respectively, and 1-year mortality of 11% and 22%.
Why the study?
Are transcatheter mitral valve-in-valve and valve-in-ring procedures safe and effective in high-risk surgical candidates?
Systematic Review
Are transcatheter mitral valve-in-valve and valve-in-ring procedures safe and effective in high-risk surgical candidates?
Absolute Event Rate: 7% vs 8%
Transcatheter mitral valve-in-valve and valve-in-ring procedures demonstrate acceptable 30-day and 1-year safety and feasibility in high-risk surgical candidates, though specific complications like LVOT obstruction and valve thrombosis require monitoring.
Urges caution in mitral VIV/VIR selection given safety concerns; extends single-registry data via pooled 30-day and 1-year outcomes.
Background The purpose of this study was to perform a systematic review and pooled analysis to evaluate 30-day and 1-year outcomes of transcatheter mitral valve-in-valve (VIV) and valve-in-ring (VIR) procedures. Data from the Valve-in-Valve Data Registry revealed that there were several safety and efficacy concerns, although procedural success was achieved in most cases. Methods Studies reporting data on either mitral VIV and/or VIR with at least five patients were pooled using weighted proportional analysis. Results The 30-day pooled estimate of all-cause mortality in the mitral VIV group was 7%, valve embolization, 5%, stroke, 3%, and major bleeding, 9%. At 1 year the all-cause mortality was 11%, valve thrombosis, 10%, stroke, 6%, and major bleeding, 16%. In the mitral VIR group, the 30-day pooled estimate for all-cause mortality was 8%, renal failure, 11%, valve embolization, 3%, and left ventricular outflow tract obstruction, 10% and at 1 year the all-cause mortality was about 22%. Conclusions Mitral VIV and VIR procedures are safe and feasible in high risk surgical candidates. The long-term safety and efficacy data beyond 1 year for both mitral VIV and VIR need to be established.
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Sengodan et al. (2018) conducted a systematic review in High risk surgical candidates requiring mitral valve intervention. Transcatheter mitral valve-in-valve (VIV) vs. Transcatheter mitral valve-in-ring (VIR) was evaluated on 30-day all-cause mortality. Transcatheter mitral valve-in-valve and valve-in-ring procedures demonstrated 30-day pooled all-cause mortality of 7% and 8%, respectively, and 1-year mortality of 11% and 22%.
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