Key result
Transseptal TMVR cuts morbidity and mortality compared to transapical access with contemporary dedicated devices.
Why the study?
Dedicated TMVR devices have emerged as a promising treatment for mitral regurgitation in high-risk patients with complex native valve anatomy, but procedural and midterm outcomes require evaluation.
Does transcatheter mitral valve replacement using contemporary dedicated devices improve outcomes in high-risk patients with native mitral regurgitation?
Meta-Analysis
Does transcatheter mitral valve replacement using contemporary dedicated devices improve outcomes in high-risk patients with native mitral regurgitation?
p-value: p=0.005
Contemporary dedicated TMVR devices demonstrate high technical success and sustained MR reduction, with transseptal access offering lower morbidity and mortality than transapical access.
Supports transseptal access for dedicated TMVR to reduce morbidity; extends evidence for sustained MR reduction in high-risk native valve disease.
Background: Dedicated transcatheter mitral valve replacement (TMVR) devices have emerged as a promising strategy for treating mitral regurgitation (MR) in high-risk patients with complex native valve anatomy. Early experience spans multiple devices utilizing both transapical and transseptal access. The aim of this study was to evaluate procedural, 30-day, and midterm outcomes of TMVR with contemporary dedicated mitral devices in patients with native MR. Methods: A systematic search of Medline, Embase, and Cochrane Library (January 2010-January 2025) was conducted. Pooled outcome estimates were derived using random-effects models, excluding legacy devices and cases of mitral stenosis. Results: = 0.005). Midterm rates of HF readmissions, major bleeding, and valve reinterventions were comparable between access routes. Conclusions: Contemporary dedicated TMVR devices demonstrate high technical success and sustained MR reduction. Transseptal access is associated with lower morbidity and mortality. Further research is needed to improve longer-term mortality and HF hospitalizations following TMVR with dedicated mitral devices.
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Zorman et al. (2025) conducted a meta-analysis in Native mitral regurgitation. Transcatheter mitral valve replacement (TMVR) using contemporary dedicated devices was evaluated on Procedural, 30-day, and midterm outcomes (p=0.005). Contemporary dedicated TMVR devices demonstrated high technical success and sustained MR reduction, with transseptal access associated with lower morbidity and mortality (P=0.005).
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