High-risk patients undergoing transcatheter mitral valve repair experience similar outcomes to patients who undergo traditional surgery.
Survival rates with catheter-based mitral valve repair are comparable to open surgery and better than conservative management in high-surgical-risk patients with severe mitral valve regurgitation.
Contemporary studies show that high-risk patients showed have similar survival at 1 year follow-up among mitral valve (MV) repair and surgery patients at 85%, and poorer survival among conservatively treated patients about 67.6%. (Swaans MJ et al),
In the above study the same trend was seen in the second and third years of follow-up, with 62.3% of MV repair patients still living after 3 years, compared with 54.2% of conservatively treated patients.
Mitral valve regurgitation, mitral insufficiency, refers to the reversal of blood flow from the left ventricle to the left atrium, and is the most common form of heart valve disease.
Patients with symptomatic MR have a poor prognosis, even with optimal medical therapy, there is no survival benefit associated with nonsurgical medical management.
Many patients are not referred for surgery because they are considered poor surgical candidates due to advanced age, left ventricular dysfunction, or other comorbidities.
Transcatheter mitral valve repair involves the creation of a double MV orifice by means of a clip in the mid portion of the anteromedial and posterolateral leaflets.
In a study of 139 consecutive patients treated with transcatheter MV repair, with outcomes compared with 53 surgically treated and 59 conservatively treated patients who were identified retrospectively; Survival rates among patients who received MV repair and surgery were better than that of conservatively treated patients at 1, 2 and 3-year follow-up.
Transcatheter mitral valve repair for degenerative MR uses an edge to edge microvalve leaflet repair technique.
Outcomes of transcatheter mitral valve repair for high risk surgical patients and isolated degenerative MR results in successful repair in almost 89% of patients (Makkah RR).
Among patients with heart failure and moderate to severe or severe secondary mitral regurgitation, who remain symptomatic, despite medical therapy, transcatheter edge to edge repair of the mitral valve, was safe and led to a lower rate of hospitalization for heart failure, and lower all cause mortality, through five years of follow up than medical therapy alone (Stone GW).