Article Impact Level: HIGH Data Quality: STRONG Summary of JACC: Cardiovascular Interventions, 16(18), 2231–2241. https://doi.org/10.1016/j.jcin.2023.06.014 Dr. Luigi Biasco et al.
Points
- Mitral transcatheter edge-to-edge repair (TEER) survival data is limited, prompting a study to estimate its impact on postprocedural life expectancy.
- The study analyzed 1,140 consecutive TEER patients aged 60 to 89, using relative survival (RS) to compare post-TEER survival to an age- and gender-matched group from Swiss mortality tables.
- Overall, 5-year survival after TEER was 59.3%, while RS reached 80.5%. RS was significantly higher for primary mitral regurgitation (PMR) patients (91.1%) compared to secondary mitral regurgitation (SMR) patients (71.5%).
- Patients aged 80 to 89 exhibited a high 5-year RS of 93.0%, with PMR patients achieving a 5-year RS of 100% when procedural success was sustained, while SMR patients achieved a 90.6% RS.
- The study’s key finding suggests that successful, sustained reduction of mitral regurgitation is crucial for improving survival, especially in the 80 to 89 age group.
Summary
In a research study that assessed the survival outcomes following mitral transcatheter edge-to-edge repair (TEER), limited data were available regarding the impact on predicted life expectancy. The study focused on patients enrolled in the MitraSwiss registry. It employed a relative survival (RS) analysis as the primary method to estimate the effects of TEER on postprocedural life expectancy.
The investigation encompassed a cohort of 1,140 consecutive TEER patients between the ages of 60 and 89, enrolled from 2011 to 2018. Relative survival was ascertained by comparing the post-TEER survival rates to the expected survival of a matched group in terms of age, gender, and calendar period, as per Swiss national mortality tables from 2011 to 2019. The principal objective was to evaluate the 5-year survival and RS following TEER. The secondary aim was to examine RS concerning mitral regurgitation etiology, age categories, and sustained procedural success over time.
The study’s results indicated that the 5-year survival rate post-TEER was 59.3%, and the RS reached 80.5%. Furthermore, the RS was notably higher at 91.1% for patients with primary mitral regurgitation (PMR) than 71.5% for secondary mitral regurgitation (SMR). Among patients aged 80 to 89, a subgroup analysis revealed a high 5-year RS of 93.0%, and in the case of PMR, a complete restoration of predicted life expectancy was observed with a 5-year RS of 100%. For SMR patients with sustained procedural success, the RS rate increased to 90.6%. The study’s conclusions underscored the critical importance of successful, sustained mitral regurgitation reduction in enhancing survival, particularly for patients in the 80 to 89 age group.
Link to the article: https://www.sciencedirect.com/science/article/abs/pii/S1936879823009846
References Biasco, L., Klersy, C., Benfari, G., Biaggi, P., Corti, R., Curti, M., Gaemperli, O., Jeger, R., Maisano, F., Mueller, O., Naegeli, B., Noble, S., Praz, F., Tersalvi, G., Toggweiler, S., Valgimigli, M., Enriquez-Sarano, M., & Pedrazzini, G. (2023). Restoration of life expectancy after transcatheter edge-to-edge mitral valve repair. JACC: Cardiovascular Interventions, 16(18), 2231–2241. https://doi.org/10.1016/j.jcin.2023.06.014
