Does Transcatheter Mitral Edge-to-Edge Repair Help All Patients with Secondary Mitral Regurgitation?

Researchers attempt to reconcile the divergent results of two randomized trials by examining participants with proportionate MR.

Researchers in two recent trials reached divergent conclusions when assessing transcatheter mitral edge-to-edge repair (TEER) for secondary mitral regurgitation (SMR) in patients with heart failure: COAPT (NCT01626079) showed efficacy, and MITRA-FR (NCT01920698) had negative results. Some commentators hypothesized that patients with less severe SMR and more left-ventricular (LV) enlargement (proportionate MR) would benefit less from TEER. These patients formed a greater proportion of the study population in MITRA-FR than in COAPT. Investigators explored the hypothesis by analyzing data on the 56 COAPT patients with proportionate MR.

The 56 patients with proportionate MR had an effective regurgitant orifice area (EROA) ≤0.30 cm² and an LV end…

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)