Association of Baseline Mitral Valve Area With Procedural and Clinical Outcomes of Mitral Transcatheter Edge-to-Edge Repair: Insights From the OCEAN-Mitral Registry

• DOI: 10.1161/circinterventions.124.014420
• Publication Date: 2024-12-17T19:00:58Z
• Authors: Kazunori Mushiake; Shunsuke Kubo; Sachiyo Ono; Takeshi Maruo; Naoki Nishiura; Kohei Osakada; Kazushige Kadota; Masanori Yamamoto; Mike Saji; Masahiko Asami; Yusuke Enta; Masaki Nakashima; Shinichi Shirai; Masaki Izumo; Shingo Mizuno; Yusuke Watanabe; Makoto Amaki; Kazuhisa Kodama; Junichi Yamaguchi; Yuki Izumi; Toru Naganuma; Hiroki Bota; Yohei Ohno; Masahiro Yamawaki; Hiroshi Ueno; Kazuki Mizutani; Toshiaki Otsuka; Kentaro Hayashida
• Keywords: MitraClip; Clinical endpoint

BACKGROUND: A small mitral valve area (MVA) is one of the challenging anatomies for transcatheter edge-to-edge repair (TEER) regurgitation, but relationship between baseline MVA and clinical outcomes remains unknown. This study aimed to evaluate association with procedural in patients undergoing TEER MitraClip from OCEAN-Mitral registry (Optimized Catheter Valvular Intervention-Mitral). METHODS: total 1768 were divided into 3 groups according MVA: group 1: <4.0 cm 2 , n=358; 2: 4.0–5.0 n=493; 3: ≥5.0 n=917. The primary end point was a composite all-cause death heart failure hospitalization within years compared groups. RESULTS: Patients smaller had significantly fewer clips implanted higher postprocedural transmitral mean pressure gradient. There no significant difference acute success rate regurgitation severity incidence similar 1 (35.2% versus 34.5% 34.0%; P =0.96) also <3.5 those 3.5 4.0 . adjusted risk relative 5.0 ≥5 remained insignificant (hazard ratio, 1.06 [95% CI, 0.79–1.41]; =0.68; hazard 0.99 0.75–1.31]; =0.96, respectively). At year, proportion residual 3+/4+ observed (7.2% 4.4% 6.5%; =0.49). CONCLUSIONS: In TEER, may limit number increase gradient after not associated reduction outcomes. REGISTRATION: URL: https://center6.umin.ac.jp/cgiope n-bin/ctr/ctr_view.cgi?recptno=R000027188 ; Unique identifier: UMIN000023653.