Safety and Feasibility of Staged Versus Concomitant Transcatheter Edge-to-Edge Mitral Valve Repair After Transcatheter Aortic Valve Implantation

Zahid, Salman; Khalouf, Amani; Hashem, Anas; Salman, Fnu; Khan, Muhammad Zia; Ullah, Waqas; Leiby, Benjamin E.; Aziz, Sundal; Atti, Varunsiri; Alkhouli, Mohamad; Balla, Sudarshan

doi:10.1016/j.amjcard.2023.01.037

Cited by 6 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patzelt et al described that mitral valve anatomy in MR patients is altered due to TAVR 23 . Lastly, a higher complication rate and longer hospital stays were reported with concomitant TAVR and TEER compared with staged TEER post-TAVR 24 , underscoring the importance of re-evaluating residual MR post-TAVR to determine optimal strategies for mitral valve intervention, avoiding routine concomitant or early-staged TEER post-TAVR.…”

Section: Discussionmentioning

confidence: 99%

Two-year clinical outcomes of staged transcatheter mitral edge-to-edge repair after transcatheter aortic valve replacement

NAGASAKA,

Patel,

Shechter

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Residual significant mitral regurgitation (MR) can increase the risk of adverse events following transcatheter aortic valve replacement (TAVR). The clinical benefits of staged transcatheter edge-to-edge repair (TEER) post-TAVR remain underexplored. This study aimed to investigate clinical outcomes of staged TEER for residual significant MR post-TAVR. Methods: This observational study included 314 consecutive patients with chronic residual grade 3+ or 4+ MR at 30 days follow-up post-TAVR, with 104 (33.1%) treated with staged TEER (TEER group) and 210 (66.9%) with medical therapy alone (MT group). The primary composite outcomes were all-cause mortality and heart failure (HF) hospitalization at 2 years. Additional analysis, including changes in MR grade and the New York Association (NYHA) functional classification, and subgroup outcome comparisons based on MR etiology were also conducted. Results: The rate of primary composite outcome was lower in the TEER group than that in the MT group (33.7% vs. 48.1%, p = 0.015). Significant improvement in MR grade and NYHA class was observed in the TEER group after 2 years. Subgroup analysis demonstrated that, among patients with degenerative MR, a lower incidence of composite outcome and HF hospitalization was observed in the TEER group (hazard ratio: 0.35; 95% confidence interval: 0.23?0.53, p < 0.001). Conclusions: Staged TEER post-TAVR was associated with reduced MR and improved clinical outcomes. The clinical significance of MR post-TAVR should be carefully evaluated, and TEER should be considered for patients with significant residual MR, particularly those with degenerative MR.

show abstract

Section: Discussionmentioning

confidence: 99%

Two-year clinical outcomes of staged transcatheter mitral edge-to-edge repair after transcatheter aortic valve replacement

NAGASAKA,

Patel,

Shechter

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Future trials should, thus, address the timing of interventions in combined VHDs. Finally, the hypothesis of concomitant TAVI and TEER during the same admission has been described in stable patients, showing no difference in in-hospital mortality, compared to staged procedures; however, increased rates of acute kidney injury, vascular complications, need for percutaneous coronary intervention, mechanical support, and pacemaker implantation are observed [ 95 ]. Interestingly, other investigators also found increased mortality, compared with isolated TAVI [ 96 ] and TAVI followed by TEER [ 97 ], which could make this approach unappealing for CS patients.…”

Section: Future Directionsmentioning

confidence: 99%

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Pyrpyris,

Dimitriadis,

Theofilis

et al. 2024

JCM

View full text Add to dashboard Cite

Structural heart disease is increasingly prevalent in the general population, especially in patients of increased age. Recent advances in transcatheter structural heart interventions have gained a significant following and are now considered a mainstay option for managing stable valvular disease. However, the concept of transcatheter interventions has also been tested in acute settings by several investigators, especially in cases where valvular disease comes as a result of acute ischemia or in the context of acute decompensated heart failure. Tested interventions include both the mitral and aortic valve, mostly evaluating mitral transcatheter edge-to-edge repair and transcatheter aortic valve implantation, respectively. This review is going to focus on the use of acute structural heart interventions in the emergent setting, and it will delineate the available data and provide a meaningful discussion on the optimal patient phenotype and future directions of the field.

show abstract

Two-Year Clinical Outcomes of Staged Transcatheter Mitral Edge-to-Edge Repair After Transcatheter Aortic Valve Replacement

Nagasaka,

Shechter,

Patel

et al. 2024

The American Journal of Cardiology

View full text Add to dashboard Cite

Safety and Feasibility of Staged Versus Concomitant Transcatheter Edge-to-Edge Mitral Valve Repair After Transcatheter Aortic Valve Implantation

Cited by 6 publications

References 16 publications

Two-year clinical outcomes of staged transcatheter mitral edge-to-edge repair after transcatheter aortic valve replacement

Two-year clinical outcomes of staged transcatheter mitral edge-to-edge repair after transcatheter aortic valve replacement

Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Two-Year Clinical Outcomes of Staged Transcatheter Mitral Edge-to-Edge Repair After Transcatheter Aortic Valve Replacement

Contact Info

Product

Resources

About