The following is a summary of “Transcatheter Edge-to-Edge Mitral Valve Repair in Patients With Severe Mitral Regurgitation and Cardiogenic Shock” published in the November 2022 issue of Cardiology by Simard et al.

There was a paucity of information about the effectiveness of transcatheter edge-to-edge repair (TEER) in patients with cardiogenic shock (CS). For a study, researchers examined the characteristics and results of a group of patients with TEER and substantial mitral regurgitation (MR) and CS.

From November 22, 2013, through December 31, 2021, the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry was evaluated. Before TEER, the definition of CS was the coding of CS, inotrope usage, or mechanical circulatory support. Device success was defined as a final MR grade of ≤2+ and an MR decrease of ≥1 grade. The influence of device success on 1-year mortality or readmissions for heart faimain result was the lure (HF) was the main result. To describe the risk-adjusted relationship between device success & 1-year outcomes, Cox proportional hazards models were utilized.

About 3,797 patients in total satisfied the requirements for inclusion. The average age was 73.0±11.9. There were 59.5% of men. 14.9% to 15.3% was the average Society of Thoracic Surgery score for MV repair. The etiology of MR was functional (27.5%) and degenerative (53.4%). 3,249 patients (85.6%) with effective end MR grade ≤2+ (88.2%) and MR decrease ≥1 absolute grade (91.4%) achieved device success. Device success was linked to significantly decreased all-cause mortality at one year following TEER (34.6 vs 55.5%; adjusted HR: 0.49; 95% CI: 0.41-0.59; P< 0.001) and a composite of death or HF hospitalizations (39.5 vs 45.2%; adjusted HR: 0.51; 95% CI: 0.42-0.62; P< 0.001). 

Most patients with CS may successfully reduce their MR, and doing so was linked to considerably decreased mortality and HF hospitalization at one year. The prospective treatment strategy had to be established by randomized studies evaluating TEER in CS.

Reference: jacc.org/doi/10.1016/j.jacc.2022.09.006