For High-Risk Patients with Severe Mitral Regurgitation, Transcatheter, Surgical, or Conservative Care?

In analyses using patient matching, MitraClip and surgery had similar 5-year survival rates, significantly better than the rate with conservative care.

To explore the possible survival advantage of MitraClip, a transcatheter system for mitral valve repair, researchers analyzed 5-year follow-up data on 568 consecutive patients with severe mitral regurgitation (MR) who underwent MitraClip at four Dutch centers from 2009 to 2016. Retrospectively selected comparison groups were 173 surgical patients and 295 conservatively treated patients in the 2 years before the centers began using the MitraClip system. MR in most patients had a functional or mixed etiology. All MitraClip patients were deemed high risk for surgery, with a mean Society of Thoracic Surgeons risk score of 8%.

After 5 years of follow-up, most (60%) of the patients in the MitraClip cohort had died. However, with multivariate adjus…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)