Procedural simplification in mitral valve transcatheter edge-to-edge repair: full echocardiographic guidance and outcomes

Background: Our group pioneered attempts to simplify the mitral valve transcatheter edge-to-edge repair (M-TEER) procedure under full echocardiographic guidance; however, its safety and effectiveness remain unclear. This study aimed to compare its outcome with the traditional procedure under echocar...

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Main Authors: Jianrui Ma, Peijian Wei, Fengwen Zhang, Junke Chang, Manchen Gao, Chuangshi Wang, Xiaofang Yan, Cheng Wang, Shouzheng Wang, Yongquan Xie, Fang Fang, Xiangbin Pan
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:International Journal of Cardiology: Heart & Vasculature
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352906725001332
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Summary:Background: Our group pioneered attempts to simplify the mitral valve transcatheter edge-to-edge repair (M-TEER) procedure under full echocardiographic guidance; however, its safety and effectiveness remain unclear. This study aimed to compare its outcome with the traditional procedure under echocardiographic and fluoroscopic co-guidance. Methods: From Jan 2021 to May 2024, 194 mitral regurgitation (MR) patients undergoing the simplified procedure (Echo guidance group, n = 113) and the traditional procedure (Co-guidance group, n = 81) were retrospectively reviewed. The propensity score matching (PSM) method was performed as a sensitivity analysis. Results: As defined by Mitral Valve Academic Research Consortium, the 30-day major adverse events, technical success, device success, and procedural success in the Echo guidance group were 5.31 %, 97.3 %, 89.4 %, and 88.5 %, similar to 8.64 %, 96.3 %, 85.2 %, and 84.0 % in the Co-guidance group, respectively (p > 0.05). Significant MR reduction and improvements in New York Heart Association functional class were observed in both groups (p < 0.05). The 1-year freedom from all-cause mortality and a composite of all-cause mortality and heart failure hospitalization were 94.5 % (95 % confidence interval (CI), 89.8 %–99.4 %) and 90.1 % (95 % CI, 83.6 %–97.2 %) in the Echo guidance group, similar to 92.1 % (95 % CI, 86.3 %–98.4 %) and 88.4 % (95 % CI, 81.6 %–95.9 %) in the Co-guidance group, respectively (p > 0.05). PSM-cohort analysis confirmed these findings. Conclusions: The simplified M-TEER procedure under full echocardiographic guidance showed comparable outcomes to the traditional procedure under echocardiographic and fluoroscopic co-guidance.
ISSN:2352-9067