TY - JOUR
T1 - Clinical outcomes of transcatheter mitral valve replacement
T2 - two-year results of the CHOICE-MI Registry
AU - Ludwig, Sebastian
AU - Perrin, Nils
AU - Coisne, Augustin
AU - Ben Ali, Walid
AU - Weimann, Jessica
AU - Duncan, Alison
AU - Akodad, Mariama
AU - Scotti, Andrea
AU - Kalbacher, Daniel
AU - Bleiziffer, Sabine
AU - Nickenig, Georg
AU - Hausleiter, Jörg
AU - Ruge, Hendrik
AU - Adam, Matti
AU - Petronio, Anna Sonia
AU - Dumonteil, Nicolas
AU - Sondergaard, Lars
AU - Adamo, Marianna
AU - Regazzoli, Damiano
AU - Garatti, Andrea
AU - Schmidt, Tobias
AU - Dahle, Gry
AU - Taramasso, Maurizio
AU - Walther, Thomas
AU - Kempfert, Joerg
AU - Obadia, Jean-François
AU - Chehab, Omar
AU - Tang, Gilbert H L
AU - Latib, Azeem
AU - Goel, Sachin S
AU - Fam, Neil P
AU - Andreas, Martin
AU - Muller, David W
AU - Denti, Paolo
AU - Praz, Fabien
AU - von Bardeleben, Ralph Stephan
AU - Granada, Juan F
AU - Modine, Thomas
AU - Conradi, Lenard
PY - 2023/8/21
Y1 - 2023/8/21
N2 - BACKGROUND: Transcatheter mitral valve replacement (TMVR) using dedicated devices is an alternative therapy for high-risk patients with symptomatic mitral regurgitation (MR).AIMS: This study aimed to assess the 2-year outcomes and predictors of mortality in patients undergoing TMVR from the multicentre CHOICE-MI Registry.METHODS: The CHOICE-MI Registry included consecutive patients with symptomatic MR treated with 11 different dedicated TMVR devices at 31 international centres. The investigated endpoints included mortality and heart failure hospitalisation rates, procedural complications, residual MR, and functional status. Multivariable Cox regression analysis was applied to identify independent predictors of 2-year mortality.RESULTS: A total of 400 patients, median age 76 years (interquartile range [IQR] 71, 81), 59.5% male, EuroSCORE II 6.2% (IQR 3.8, 12.0), underwent TMVR. Technical success was achieved in 95.2% of patients. MR reduction to ≤1+ was observed in 95.2% at discharge with durable results at 1 and 2 years. New York Heart Association Functional Class had improved significantly at 1 and 2 years. All-cause mortality was 9.2% at 30 days, 27.9% at 1 year and 38.1% at 2 years after TMVR. Chronic obstructive pulmonary disease, reduced glomerular filtration rate, and low serum albumin were independent predictors of 2-year mortality. Among the 30-day complications, left ventricular outflow tract obstruction, access site and bleeding complications showed the strongest impact on 2-year mortality.CONCLUSIONS: In this real-world registry of patients with symptomatic MR undergoing TMVR, treatment with TMVR was associated with a durable resolution of MR and significant functional improvement at 2 years. Two-year mortality was 38.1%. Optimised patient selection and improved access site management are mandatory to improve outcomes.
AB - BACKGROUND: Transcatheter mitral valve replacement (TMVR) using dedicated devices is an alternative therapy for high-risk patients with symptomatic mitral regurgitation (MR).AIMS: This study aimed to assess the 2-year outcomes and predictors of mortality in patients undergoing TMVR from the multicentre CHOICE-MI Registry.METHODS: The CHOICE-MI Registry included consecutive patients with symptomatic MR treated with 11 different dedicated TMVR devices at 31 international centres. The investigated endpoints included mortality and heart failure hospitalisation rates, procedural complications, residual MR, and functional status. Multivariable Cox regression analysis was applied to identify independent predictors of 2-year mortality.RESULTS: A total of 400 patients, median age 76 years (interquartile range [IQR] 71, 81), 59.5% male, EuroSCORE II 6.2% (IQR 3.8, 12.0), underwent TMVR. Technical success was achieved in 95.2% of patients. MR reduction to ≤1+ was observed in 95.2% at discharge with durable results at 1 and 2 years. New York Heart Association Functional Class had improved significantly at 1 and 2 years. All-cause mortality was 9.2% at 30 days, 27.9% at 1 year and 38.1% at 2 years after TMVR. Chronic obstructive pulmonary disease, reduced glomerular filtration rate, and low serum albumin were independent predictors of 2-year mortality. Among the 30-day complications, left ventricular outflow tract obstruction, access site and bleeding complications showed the strongest impact on 2-year mortality.CONCLUSIONS: In this real-world registry of patients with symptomatic MR undergoing TMVR, treatment with TMVR was associated with a durable resolution of MR and significant functional improvement at 2 years. Two-year mortality was 38.1%. Optimised patient selection and improved access site management are mandatory to improve outcomes.
KW - Aged
KW - Cardiac Catheterization/methods
KW - Female
KW - Heart Valve Prosthesis
KW - Heart Valve Prosthesis Implantation/methods
KW - Humans
KW - Male
KW - Mitral Valve Insufficiency
KW - Mitral Valve/surgery
KW - Registries
KW - Risk Factors
KW - Treatment Outcome
KW - miscellaneous
KW - mitral regurgitation
KW - transapical
KW - transseptal
KW - access site
UR - https://pubmed.ncbi.nlm.nih.gov/37235388/
U2 - 10.4244/EIJ-D-22-01037
DO - 10.4244/EIJ-D-22-01037
M3 - Journal article
C2 - 37235388
SN - 1774-024X
VL - 19
SP - 512
EP - 525
JO - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
JF - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
IS - 6
ER -