Key result
Transcatheter mitral valve-in-valve and valve-in-ring show comparable short-term mortality to redo surgical mitral valve replacement.
Why the study?
Transcatheter valve-in-valve or valve-in-ring therapies for degenerated mitral bioprosthetic valves and rings are still evolving, and their short- and long-term outcomes required characterization.
What are the short- and long-term clinical outcomes of transcatheter mitral valve-in-valve and valve-in-ring implantation compared to redo surgical mitral valve replacement in patients with degenerated mitral bioprostheses?
Meta-Analysis (n=7,047)
What are the short- and long-term clinical outcomes of transcatheter mitral valve-in-valve and valve-in-ring implantation compared to redo surgical mitral valve replacement in patients with degenerated mitral bioprostheses?
Absolute Event Rate: 6.4% vs 8.4%
Transcatheter mitral VIV and VIR demonstrate high procedural success and favorable short-term mortality and stroke risks compared to redo surgical mitral valve replacement.
May support transcatheter mitral VIV/VIR in high-risk patients; extends observational meta-analyses but leaves long-term durability open.
BACKGROUND: Transcatheter valve-in-valve (VIV) or valve-in-ring (VIR) therapies for degenerated mitral bioprosthetic valves and rings are still evolving. We aimed to characterize short- and long-term outcomes of these procedures. METHODS: An electronic literature search was conducted to retrieve articles describing mitral VIV or VIR implantation with at least 10 patients. Meta-analysis of proportions was carried out for 30-day or in-hospital outcomes of mortality, stroke, major bleeding, transfusion, acute kidney injury, procedural success, valve embolization, paravalvular leak, pacemaker implantation, and hospital stay. Individual patient data meta-analysis using Kaplan-Meier curve reconstruction was used to estimate long-term mortality of VIV, VIR and redo surgical mitral valve replacement (SMVR). RESULTS: We analyzed 34 studies (7047 patients). Pooled procedural success was 94.8% in VIV and 80.5% in VIR. Pooled short-term mortality and stroke risk was 6.4% and 1.9% respectively in VIV, 9.1% and 1.6% respectively in VIR, and 8.4% and 5.5% respectively in SMVR. CONCLUSIONS: This study provides prognostic information on clinical outcomes for redo SMVR and transcatheter mitral VIV and VIR implantation.
No takes yet. Share an insight, caveat, or question.
Fong et al. (2024) conducted a meta-analysis in degenerated mitral bioprosthetic valves and rings (n=7,047). Transcatheter mitral valve-in-valve (VIV) and valve-in-ring (VIR) implantation vs. redo surgical mitral valve replacement (SMVR) was evaluated on short-term mortality. Transcatheter mitral valve-in-valve and valve-in-ring implantation had short-term mortality rates of 6.4% and 9.1%, respectively, compared to 8.4% for redo surgical mitral valve replacement.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: