Abstract 20125: MitraClip Acute Outcomes are Similar in Functional vs. Degenerative Mitral Regurgitation: A Meta-analysis of Observational Studies
Introduction: Percutaneous mitral valve repair using MitraClip (MC) is recommended by 2014 AHA/ACC valvular heart disease guidelines, only for inoperable symptomatic chronic degenerative MR (DMR) patients on optimal medical therapy (Class IIb). However outside USA, MC is extensively utilized for severe functional MR (FMR), with some recent registries suggesting increased success with FMR when compared to DMR. Randomized control trials to evaluate MC success in functional MR are ongoing.
Aim: To evaluate the short term efficacy and safety of MC in FMR vs. DMR
Methods and Results: PubMed, EMBASE, Google scholar database and international meeting abstracts were searched for all observational MC studies. Studies which did not specify type of MR or where post-procedural results were not delineated between the types of MR were excluded from the analysis. We defined acute procedural success (APS) in our analysis as decrease in MR severity to ≤ 2 at the time of discharge or within 30 days post procedure and MACE as composite 30 day myocardial infarction, stroke, and all-cause mortality.
We included 8 observational studies, total of 1452 patients with 806 patients in FMR vs. 552 patients in DMR. Meta-analysis was performed with intention to treat principle. Pooled analysis using random effects model (Mantel- Haenszel test) was performed for acute procedural success and results were similar for both FMR and DMR (OR=0.93, p=0.82). Short term MACE events, including death were similar in both groups (OR=0.57, p=0.15). Cumulative procedural success rates with MC was 89% for both FMR and DMR.
Conclusion: To date, this is the first meta-analysis suggesting MitraClip therapy to be of equal efficacy and safety at short term follow up for both functional and degenerative MR.
Author Disclosures: S. Gaddam: None. V. Agarwal: None. A. Soomro: None. B. Pandya: None. S. Duvvuri: None. D. McCord: None. J. Lafferty: None. R. Kandov: None. R. Royzman: None. M. Cottone: None. C. Kliger: Honoraria; Modest; Philips Healthcare, St Jude Medical.
- © 2014 by American Heart Association, Inc.