Does having technological advancements and increasing operator experiences made transcatheter mitral valve repair (TMVR) safer for patients with severe symptomatic degenerative mitral regurgitation at prohibitive risk of surgery? The overall answer may be yes, according to new research presented Sept. 25 at TCT 2019 and simultaneously published in JACC: Cardiovascular Interventions.

Researchers, led by Michael J. Hendrickson, of the University of North Carolina School of Medicine, Chapel Hill, identified hospitalizations from the Healthcare Cost and Utilization Project and National Readmission Database (NRD) between January 2012 and November 2016 in which patients were undergoing elective TMVR (3,269/18 percent) or surgical mitral valve repair (SAVR) (14,819/82 percent). They then assessed linear temporal trends in patient outcomes and heart failure (HF) readmissions post-TMVR as compared with SMVR.

Overall results found the proportion of TMVR procedures substantially increased from 5 percent in 2012 to 58 percent in 2016, with TMVR patients more likely to be older and male. Additionally, the incidence of adverse events, including inpatient mortality, blood transfusion and HF readmissions decreased for TMVR patients during the time period. The composite endpoint of inpatient stroke, inpatient mortality, and 30-day HF readmissions also decreased (8.0 percent to 5.6 percent). Researchers did note the incidence of inpatient ischemic stroke remained relatively stable.

For SMVR patients, there were no significant differences in age and sex of patients. Researchers also saw an increase in inpatient mortality, HF readmissions and inpatient ischemic stroke between 2012 and 2016. The composite endpoint following SMVR also increased from 4.7 percent to 6.3 percent. A decrease in the incidence of blood transfusions, however, was observed.

"Overall, TMVR seems to have become safer over time," researchers said. However, they suggest additional research is needed to further confirm their findings.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: TCT19, Transcatheter Cardiovascular Therapeutics, Angiography

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