Approximately 1 in 5 patients admitted for cardiogenic shock (CS) were observed to have moderate to severe mitral insufficiency (MI), which increases the risk of mortality by about 60%. To date, there is limited data on the role of transcatheter edge-to-edge repair therapy in this setting.
The aim of this study was to describe the risk profile, device success, and association between device implantation and events at 1 year. Data were obtained from 3797 patients; their mean age was 73±11 years; 59.9% of patients were men and the STS mortality risk was 14.9±15.3, with a mean ejection fraction of 41±17.5%.
In 47.8% of patients, there was more than 1 clip implanted. Complications observed included major bleeding (3.6%), life-threatening bleeding (4%), and stroke (1.6%), with an average hospitalization of 12.5 days.
Successful implantation was achieved in 85.6% of the cases. In patients who underwent successful implantation, there was a 51% decrease in mortality compared with failed implantation (hazard ratio [HR]: 0.49; 95% confidence interval [CI]: 0.41-0.59; p < 0.001), with a need-to-treat of 4.8. When analyzing the composite outcome of mortality/hospitalization for heart failure, the reduction was 49% (HR: 0.51; 95% CI: 0.42-0.62; p < 0.001).
Conclusions
The reduction of MI within CS is achievable in most patients and is associated with a decrease in mortality and hospitalizations at 1 year. Data come from registries and, therefore, only suggest a hypothesis to be addressed in the future.
Dr. Omar Tupayachi.
Member of the Editorial Board of SOLACI.org.
Font: Transcatheter Edge-to-Edge Repair in Patients with Severe Mitral Regurgitation and
Reference: Cardiogenic Shock: TVT Registry Analysis presentado por Mohamad A. Alkhouli, MD en TCT Congress, Boston, EE. UU. 17 septiembre de 2022.
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