The Significance of Aetiology on Mitral Regurgitation

Courtesy of Dr. Carlos Fava.

The aetiology of mitral regurgitation (MR) may be divided into primary, organic or degenerative MR, and secondary or functional MR. These two present different physiopathology. The treatment strategy is different for each, and edge-to-edge treatment with Mitraclip is currently emerging as a valid alternative for high-risk patients.

TAVI en bajo riesgo con “cero” mortalidad y “cero” strokeThis study analyzed 943 patients with MR and high surgical risk. Among them, 668 had functional causes (FMR) and 275 had degenerative causes (DMR).

 

For patients with FMR, the mean age was 72 years, the EuroSCORE II was 7.4, and the ejection fraction was 33%.

 

Three hundred and sixty-five patients received MitraClip, 95 underwent surgery (valve repair, mostly), and the remaining 228 patients received medical treatment.


Read also: TCT 2018 | REDUCE-FMR: Indirect Annuloplasty in Secondary Mitral Regurgitation.


The groups presented differences. Patients who received MitraClip were elderly compared with the group undergoing surgery, but similar in age to the group who received medical treatment. However, their risk score and comorbidities were higher than for the other two groups.

 

In the MitraClip group, procedural success was 97%.

 

Propensity score matching and Cox regression were used to reduce confounding variables among groups.


Read also: TCT 2018 | COAPT: MitraClip in Patients with Secondary Mitral Regurgitation.


After a 3-year follow-up, the medical treatment group presented higher mortality rates than the MitraClip group (hazard ratio [HR] 1.79; 95% confidence interval [CI]: 1.34 to 2.39; p < 0.001). On the other hand, there were no differences between the surgery group and the MitraClip group (HR: 0.86; 95% CI: 0.54 to 1.38; p = 0.541).

 

As regards DMR patients, there were no significant differences among strategies.

 

Conclusions

In high-risk FMR patients, MitraClip showed a reduction in mortality compared with medical treatment.

 

Courtesy of Dr. Carlos Fava.

 

Original title: Impact of Mitral Valve Treatment Choice on Mortality According to Aetiology.

Reference: Friso Kortlandt et al. EuroIntervention 2019;14:1733-1739.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

Prospective Analysis of the Feasibility of the PASCAL System for Transcatheter Mitral Repair: OneForAll Registry

Courtesy of Dr. Juan Manuel Pérez. Mitral transcatheter edge-to-edge repair (M-TEER) is an effective option for patients with severe mitral regurgitation who are at high...

Left Bundle Branch Block after TAVR: What Is Its Impact?

Courtesy of Dr. Juan Manuel Pérez. Left bundle branch block (LBBB) is a common complication following transcatheter aortic valve replacement (TAVR), which can be either...

Multicenter Experience with 3D Intracardiac Echocardiography for Guiding Interventional Cardiac Procedures

Courtesy of Dr. Juan Manuel Pérez. Imaging techniques play a fundamental role in interventional cardiac procedures. Intracardiac echocardiography (ICE) appears as an alternative to transesophageal...

Pathology of Self-Expanding Transcatheter Aortic Bioprostheses and Hypoattenuated Leaflet Thickening

Courtesy of Dr. Juan Manuel Pérez. Despite the available long term followup data on of transcatheter aortic valve replacement (TAVR), bioprosthesis durability continues under debate....

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

STRIDE: Semaglutide in Patients with Peripheral Arterial Disease and Type II Diabetes

Peripheral arterial disease (PAD) is a severe complication in patients with type II diabetes, primarily affecting peripheral vessels, especially below-the-knee (BTK) arteries. This condition...