Key result
In hemodynamically unstable patients with severe mitral regurgitation, residual moderate-to-severe or severe MR following mitral valve transcatheter edge-to-edge repair was significantly correlated with 30-day mortality (coefficient β = 3.48).
Why the study?
Outcomes after mitral valve transcatheter edge-to-edge repair (M-TEER) in patients with severe mitral regurgitation and hemodynamic instability remain unclear.
Does mitral valve transcatheter edge-to-edge repair (M-TEER) improve short-term outcomes in hemodynamically unstable patients with severe mitral regurgitation?
Meta-Analysis
Does mitral valve transcatheter edge-to-edge repair (M-TEER) improve short-term outcomes in hemodynamically unstable patients with severe mitral regurgitation?
Effect estimate: coefficient β = 3.48 (95% CI 0.99-5.97)
p-value: p=0.006
M-TEER is a feasible treatment option that can provide favorable short-term outcomes for hemodynamically unstable patients with severe mitral regurgitation, though procedural complications such as acute kidney injury are relatively common.
BACKGROUND: The outcomes after mitral valve transcatheter edge-to-edge repair (M-TEER) for the patients with severe mitral regurgitation (MR) in hemodynamically unstable conditions, such as cardiogenic shock, still remain unclear. We aimed to integrate previous publications regarding M-TEER indicated for life-threatening conditions and indirectly particularly compared the short-term outcomes thereof, with that of other treatments. METHODS: We systematically searched the PubMed, Cochrane, and MEDLINE databases for studies from inception to June 2023, regarding M-TEER in patients with hemodynamic instability and severe MR. The primary outcomes analyzed included the in-hospital and 30-day mortality rates, and peri-procedural complications. RESULTS: = 35.5 %), respectively. The 30-day mortality rate was statistically significantly correlated with the residual moderate-to-severe or severe MR, as per the meta-regression analysis (coefficient β = 3.48 [95 % CI: 0.99-5.97], p = 0.006). Regarding peri-procedural complications, the pooled rates of a stroke or transient ischemic attack, life-threatening or major bleeding, acute kidney injury, and peri-procedural mitral valve surgery were 2.3 % (95 % CI: 1.9-2.6), 7.6 % (95 % CI: 6.8-8.5), 32.9 % (95 % CI: 31.6-34.3), and 1.0 % (95 % CI: 0.8-1.3), respectively. CONCLUSIONS: This meta-analysis demonstrates that the relatively higher rates of procedural complications were observed, nevertheless, M-TEER can potentially provide favorable short-term outcomes even in hemodynamically unstable patients. PROSPERO REGISTRATION NUMBER: CRD42023468946.
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Yokoyama et al. (2024) conducted a meta-analysis in Severe mitral regurgitation in hemodynamically unstable conditions. Mitral valve transcatheter edge-to-edge repair (M-TEER) was evaluated on Correlation of 30-day mortality rate with residual moderate-to-severe or severe MR (coefficient β = 3.48, 95% CI 0.99-5.97, p=0.006). In hemodynamically unstable patients with severe mitral regurgitation, residual moderate-to-severe or severe MR following mitral valve transcatheter edge-to-edge repair was significantly correlated with 30-day mortality (coefficient β = 3.48).
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