Restoration of Life Expectancy After Transcatheter Edge-to-Edge Mitral Valve Repair.

Biasco, Luigi; Klersy, Catherine; Benfari, Giovanni; Biaggi, Patric; Corti, Roberto; Curti, Moreno; Gaemperli, Oliver; Jeger, Raban; Maisano, Francesco; Mueller, Olivier; Naegeli, Barbara; Noble, Stephane; Praz, Fabien; Tersalvi, Gregorio; Toggweiler, Stefan; Valgimigli, Marco; Enriquez-Sarano, Maurice; Pedrazzini, Giovanni (2023). Restoration of Life Expectancy After Transcatheter Edge-to-Edge Mitral Valve Repair. JACC. Cardiovascular Interventions, 16(18), pp. 2231-2241. Elsevier 10.1016/j.jcin.2023.06.014

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BACKGROUND

Survival data after mitral transcatheter edge-to-edge repair (TEER) are scarce, and its impact on predicted life expectancy is unknown.

OBJECTIVES

The aim of this study was to estimate the impact of TEER on postprocedural life expectancy among patients enrolled in the MitraSwiss registry through a relative survival (RS) analysis.

METHODS

Consecutive TEER patients 60 to 89 years of age enrolled between 2011 and 2018 (N = 1140) were evaluated. RS was defined as the ratio between post-TEER survival and expected survival in an age-, sex- and calendar period-matched group derived from the Swiss national 2011 to 2019 mortality tables. The primary aim was to assess 5-year survival and RS after TEER. The secondary aim was to assess RS according to the etiology of mitral regurgitation, age class and sustained procedural success over time.

RESULTS

Overall, 5-year survival after TEER was 59.3% (95% CI: 54.9%-63.4%), whereas RS reached 80.5% (95% CI: 74.6%-86.0%). RS was 91.1% (95% CI: 82.5%-98.6%) in primary mitral regurgitation (PMR) and 71.5% (95% CI: 63.0%-79.3%) in secondary mitral regurgitation (SMR). Patients 80 to 89 years of age (n = 579) showed high 5-year RS (93.0%; 95% CI: 83.3%-101.9%). In this group, restoration of predicted life expectancy was achieved in PMR with a 5-year RS of 100% (95% CI: 87.9%-110.7%), whereas sustained procedural success increased the RS rate to 90.6% (95% CI: 71.3%-107.3%) in SMR.

CONCLUSIONS

Mitral TEER in patients 80 to 89 years of age is able to restore predicted life expectancy in PMR, whereas in SMR with sustained procedural success, high RS estimates were observed. Our analysis suggests that successful, sustained mitral regurgitation reduction is key to survival improvement, particularly in patients 80 to 89 years of age.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Praz, Fabien Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1876-7605

Publisher:

Elsevier

Language:

English

Submitter:

Tanja Gilgen

Date Deposited:

28 Dec 2023 15:57

Last Modified:

28 Dec 2023 15:57

Publisher DOI:

10.1016/j.jcin.2023.06.014

PubMed ID:

37632476

Uncontrolled Keywords:

edge-to-edge mitral valve repair mitral regurgitation mortality percutaneous mitral valve repair relative survival

BORIS DOI:

10.48350/190904

URI:

https://boris.unibe.ch/id/eprint/190904

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