Isolated Mitral Regurgitation Versus Multivalvular Disease in Patients Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair: A Comparison of Cardiac Function and Structure

Document Type

Conference Proceeding

Publication Date

2-1-2024

Publication Title

Cardiovasc Revasc Med

Abstract

Background Mitral transcatheter edge to edge repair is effective in the treatment of mitral regurgitation. Multivalvular disease (MVD) encompasses different concurrent valvular lesions that modify cardiac function and structure. The effect of mitral TEER on cardiac function and structure in isolated MR and MVD is unclear. Methods A single-center retrospective analysis was performed. Mitral TEER procedures performed in a seven-year period from 2017 to 2023 that were technically successful were included. Patient demographics, echocardiogram data at baseline and post-procedure, clinical outcomes were evaluated. Mean, median, and standard deviation were compared. Equal variance two sample t-test was used to assess statistical significance. Results Among all 401 cases of mitral TEER, mean baseline LVEF was 50.2% ± 13.8% and post-TEER was 48.8% ± 15.0%; relative change -2.8% (p=0.09). Mean LVEF in cases with isolated MR pre-TEER was 50.6% and post-TEER was 49.6%; relative change -2.0% (p=0.27). Mean LVEF in cases with MR and TR pre-TEER was 50.4% and post-TEER was 48.6%; relative change -3.6% (p=0.12). Mean LVEF in cases with MR and AR pre-TEER was 47.5% and post-TEER was 44.3%; relative change -6.7% (p=0.11). Mean LVEF in cases with MR and TR and AR pre-TEER was 48.5% and post-TEER was 44.0%; relative change was -9.3% (p=0.11). LA size in all cases pre-TEER was normal in 20.0% (n=80), dilated in 69.8% (n=280), and not quantified in 10.2% (n=41). LA size in all cases post-TEER was normal in 16.7% (n=67), dilated in 72.1% (n=289), and not quantified in 11.2% (n=45). Changes in LVEF and LA size after intervention including subgroup analysis were not statistically significant. Conclusion Patients who underwent mitral TEER had a mildly depressed LVEF at baseline with mild decrease in EF post TEER intervention. Patients with MVD had a lower baseline LVEF compared to those with isolated MR. LVEF decline after TEER procedure trended towards greater decline in patients with more complex valvular disease. Cardiac remodeling in the setting of valvular heart disease involves an interplay of factors. Larger studies with longer term follow-up will be necessary to evaluate impact of TEER in cardiac remodeling across different cardiac anatomies.

Volume

65

First Page

73

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