transcatheter mitral valve repair; transcatheter mitral edge-to-edge repair (TEER)
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Indications
- secondary mitral regurgitation in patients with NYHA heart failure class III or IV[8]
* transcatheter mitral valve repair improves survival in high surgical risk patients with severe mitral regurgitation[2]
* 5-year advantage over medical care for patients with moderate-severe mitral regurgitation[9]
Procedure
- MitraClip, a transcatheter system for mitral valve repair in patients with high surgical risk[8]
- MitraClip device FDA-approved 2013 for patients with heart failure[3]
- transcatheter edge-to-edge repair (TEER) with MitraClip for patients with heart failure & secondary mitral regurgitation[5]
- LVEF 20-50%, LV end-diastolic diameter < 7 cm[8]
- similar 5 year outcomes to surgery in patients with severe mitral regurgitation (5 year survival 40%)[10]
- 1,100 reports of patient deaths[11]
* MitraClip system (illustration)[11]
Complications
- transcatheter mitral valve repair
- mortality: 2.7% in-hospital, 5% at 30 days, 26% at 1 year[4]
- rehospitalization within 1-year for heart failure in 20%[4]
Notes
- increasing use of transcatheter mitral valve repair vs surgical repair after approval of MitraClip (Abbott) in 2013, surpassing surgical repair in 2018[7]
More general terms
Additional terms
References
- ↑ Lindenfeld J, Abraham WT, Grayburn PA et al. Association of effective regurgitation orifice area to left ventricular end-diastolic volume ratio with transcatheter mitral valve repair outcomes: A secondary analysis of the COAPT trial. JAMA Cardiol 2021 Feb 3; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33533873 https://jamanetwork.com/journals/jamacardiology/article-abstract/2775801
Gillam LD. Reconciling COAPT and Mitra-FR results based on mitral regurgitation severity and left ventricular size: It's not so simple. JAMA Cardiol 2021 Feb 3; PMID: https://www.ncbi.nlm.nih.gov/pubmed/33533877 https://jamanetwork.com/journals/jamacardiology/article-abstract/2775799 - ↑ Jump up to: 2.0 2.1 Swaans MJ et al. Survival of transcatheter mitral valve repair compared with surgical and conservative treatment in high-surgical-risk patients. JACC Cardiovasc Interv 2014 Aug; 7:875. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25147032
Bonow RO. The saga continues: Does mitral valve repair improve survival in secondary mitral regurgitation? JACC Cardiovasc Interv 2014 Aug; 7:882 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25147033 - ↑ Jump up to: 3.0 3.1 FDA News Release. March 14, 2019 FDA approves new indication for valve repair device to treat certain heart failure patients with mitral regurgitation. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm633479.htm
- ↑ Jump up to: 4.0 4.1 4.2 Sorajja PSorajja P, Vemulapalli S, Feldman T et al. Outcomes with transcatheter mitral valve repair in the United States: An STS/ACC TVT registry report. J Am Coll Cardiol 2017 Nov 7; 70:2315. (http://dx.doi.org/10.1016/j.jacc.2017.09.015 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29096801
Bolling SF. First TMVR enters U.S. market as a therapy, and a gateway. J Am Coll Cardiol 2017 Nov 7; 70:2328 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29096802 - ↑ Jump up to: 5.0 5.1 Mack MJ, Lindenfeld J, Abraham WT et al. 3-year outcomes of transcatheter mitral valve repair in patients with heart failure. J Am Coll Cardiol 2021 Mar 2; 77:1029. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33632476 https://www.sciencedirect.com/science/article/abs/pii/S0735109720382656
Depta JP, Bhatt DL. Crossover in COAPT: Does this extend the reach of TMVr for treating functional MR? J Am Coll Cardiol 2021 Mar 2; 77:1041 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33632477 https://www.sciencedirect.com/science/article/abs/pii/S0735109721000036 - ↑ Davidson LJ, Davidson CJ Transcatheter Treatment of Valvular Heart Disease. A Review. JAMA. 2021;325(24):2480-2494 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34156404 https://jamanetwork.com/journals/jama/fullarticle/2781245
- ↑ Jump up to: 7.0 7.1 Young MN, Kearing S, Albaghdadi MA et al Trends in Transcatheter vs Surgical Mitral Valve Repair Among Medicare Beneficiaries, 2012 to 2019. JAMA Cardiol. 2022. May 4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35507335 https://jamanetwork.com/journals/jamacardiology/fullarticle/2791890
- ↑ Jump up to: 8.0 8.1 8.2 8.3 Medical Knowledge Self Assessment Program (MKSAP) 19 American College of Physicians, Philadelphia 2022
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ Jump up to: 9.0 9.1 Stone GW et al. Five-year follow-up after transcatheter repair of secondary mitral regurgitation. N Engl J Med 2023 Mar 5; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/36876756 https://www.nejm.org/doi/10.1056/NEJMoa2300213
- ↑ Jump up to: 10.0 10.1 Kortlandt F, Velu J, Schurer R et al. Survival after MitraClip treatment compared to surgical and conservative treatment for high-surgical-risk patients with mitral regurgitation. Circ Cardiovasc Interv 2018 Jun; 11:e005985. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29895598 https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.117.005985
Sorajja P, Gossl M. Waiting to exhale: Transcatheter repair of mitral regurgitation and survival. Circ Cardiovasc Interv 2018 Jun; 11:e006749. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29895604 https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.118.006749 - ↑ Jump up to: 11.0 11.1 11.2 Hilzenrath D, Hacker KK When Medical Devices Malfunction. From Dr. Oz to Heart Valves: A Tiny Device Charted a Contentious Path Through the FDA. KFF Health News. 2024. July 9. https://kffhealthnews.org/news/article/mitraclip-heart-valve-device-dr-oz-fda/