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. 2024 Feb 28;13(5):1372.
doi: 10.3390/jcm13051372.

Transcatheter Edge-to-Edge Mitral Valve Repair versus Minimally Invasive Mitral Valve Surgery: An Observational Study

Miriam Silaschi  1 , Franca Cattelaens  1 , Hossien Alirezaei  1 , Johanna Vogelhuber  2 , Susanne Sommer  3 , Atsushi Sugiura  2 , Max Schulz  2 , Tetsu Tanaka  2 , Mitsumasa Sudo  2 , Sebastian Zimmer  2 , Georg Nickenig  2 , Marcel Weber  2 , Farhad Bakhtiary  1 , Nihal Wilde  2
Affiliations

Transcatheter Edge-to-Edge Mitral Valve Repair versus Minimally Invasive Mitral Valve Surgery: An Observational Study

Miriam Silaschi et al. J Clin Med. .

Abstract

Background: Minimally invasive mitral valve surgery (MIC-MVS) has been established as preferred treatment of mitral regurgitation (MR), but mitral transcatheter edge-to-edge valve repair (M-TEER) is routinely performed in patients at high surgical risk and is increasingly performed in intermediate risk patients. Methods: From 2010 to 2021, we performed 723 M-TEER and 123 isolated MIC-MVS procedures. We applied a sensitivity analysis by matching age, left ventricular ejection fraction (LVEF), EuroSCORE II and etiology of MR. Results: Baseline characteristics showed significant differences in the overall cohort (p < 0.01): age 78.3 years vs. 61.5 years, EuroSCORE II 5.5% vs. 1.3% and LVEF 48.4% vs. 60.4% in M-TEER vs. MIC-MVS patients. Grade of MR at discharge was moderate/severe in 24.5% (171/697) in M-TEER vs. 6.5% (8/123) in MIC-MVS (p < 0.01). One-year survival was 91.5% (552/723) in M-TEER vs. 97.6% (95/123) in MIC-MVS (p = 0.04). A matching with 49 pairs (n = 98) showed comparable survival during follow-up, but a numerically higher mean mitral valve gradient of 4.1 mmHg (95% CI: 3.6-4.6) vs. 3.4 mmHg (95% CI: 3.0-3.8) in M-TEER (p = 0.04). Conclusions: Patients undergoing M-TEER had lower one-year survival than MIC-MVS, but differences disappeared after matching. Reduction in MR was less effective in M-TEER patients and postprocedural mitral valve gradients were higher.

Keywords: edge-to-edge repair; innovations; microinvasive cardiac surgery; minimally invasive cardiac surgery; mitral regurgitation; mitral valve surgery.

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Conflict of interest statement

Miriam Silaschi has received research grants from Medtronic, LSI solutions and Cryolife Inc. and travel c ompensation from Edwards Lifesciences Inc. and is an advisory board member for JenaValve Technologies. Atsushi Sugiura has received honoraria for lectures from Edwards Lifesciences. Tetsu Tanaka has been financially supported in part by a Fellowship from the Japanese College of Cardiology and the Uehara Memorial Foundation. Georg Nickenig and Sebastian Zimmer have received research funding from the Deutsche Forschungsgemeinschaft, the German Federal Ministry of Education and Research, the EU, Abbott, Edwards Lifesciences and Medtronic and have received honoraria for lectures or advisory boards from Abbott, Edwards Lifesciences and Medtronic. Marcel Weber has received lecture or proctoring fees from Abbott and Edwards Lifesciences. The other authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Study results of the overall cohort. (A) Kaplan–Meier curves of one-year survival in the mitral transcatheter edge-to-edge valve repair (M−TEER) and minimally invasive mitral valve surgery (MIC−MVS) groups. (B) Changes in the severity of MR grades at one year follow-up for both procedures as paired analyses. (C) Distribution of NYHA classes at baseline and one year as paired analyses. (D) Follow-up data. Legend: M-TEER = mitral transcatheter edge-to-edge repair valve repair; MIC−MVS = minimally invasive mitral valve surgery; NYHA = New York Heart Association; MR = mitral regurgitation; MV = mitral valve.
Figure 2
Figure 2
Study results of the matched cohort. (A) Kaplan–Meier curves of one-year survival in the mitral transcatheter edge-to-edge valve repair (M−TEER) and minimally invasive mitral valve surgery (MIC−MVS) groups. (B) Changes in the severity of MR grades at one year follow-up for both procedures as paired analyses. (C) Distribution of NYHA classes at baseline and one year as paired analyses. (D) Follow−up data. Legend: M−TEER = mitral transcatheter edge−to−edge repair valve repair; MIC-MVS = minimally invasive mitral valve surgery; NYHA = New York Heart Association; MR = mitral regurgitation; MV = mitral valve.
Figure 3
Figure 3
Survival rates of patients with degenerative mitral valve disease—subanalysis. (A) Kaplan–Meier curves of one-year survival in patients with degenerative mitral valve disease after mitral transcatheter edge-to-edge valve repair (M-TEER) and minimally invasive mitral valve surgery (MIC-MVS) in the overall cohort. (B) Kaplan–Meier curves of one-year survival in patients with degenerative mitral valve disease after mitral transcatheter edge-to-edge valve repair (M-TEER) and minimally invasive mitral valve surgery (MIC-MVS) in the matched cohort. Legend: M-TEER = mitral transcatheter edge-to-edge repair valve repair; MIC-MVS = minimally invasive mitral valve surgery.
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References

    1. Goldstone A.B., Atluri P., Szeto W.Y., Trubelja A., Howard J.L., MacArthur J.W., Jr., Newcomb C., Donnelly J.P., Kobrin D.M., Sheridan M.A., et al. Minimally invasive approach provides at least equivalent results for surgical correction of mitral regurgitation: A propensity-matched comparison. J. Thorac. Cardiovasc. Surg. 2013;145:748–756. doi: 10.1016/j.jtcvs.2012.09.093. - DOI - PMC - PubMed
    1. Cheng D.C., Martin J., Lal A., Diegeler A., Folliguet T.A., Nifong L.W., Perier P., Raanani E., Smith J.M., Seeburger J., et al. Minimally invasive versus conventional open mitral valve surgery: A meta-analysis and systematic review. Innovations. 2011;6:84–103. - PubMed
    1. Falk V., Cheng D.C., Martin J., Diegeler A., Folliguet T.A., Nifong L.W., Perier P., Raanani E., Smith J.M., Seeburger J. Minimally invasive versus open mitral valve surgery: A consensus statement of the international society of minimally invasive coronary surgery (ISMICS) 2010. Innovations. 2011;6:66–76. - PubMed
    1. Sündermann S.H., Sromicki J., Biefer H.R.C., Seifert B., Holubec T., Falk V., Jacobs S. Mitral valve surgery: Right lateral minithoracotomy or sternotomy? A systematic review and meta-analysis. J. Thorac. Cardiovasc. Surg. 2014;148:1989–1995.e4. doi: 10.1016/j.jtcvs.2014.01.046. - DOI - PubMed
    1. Beckmann A., Meyer R., Lewandowski J., Markewitz A., Blaßfeld D., Böning A. German Heart Surgery Report 2022: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery. Thorac. Cardiovasc. Surg. 2023;71:340–355. doi: 10.1055/s-0043-1769597. - DOI - PubMed

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