Chiarito M, et al. - This study compared safety and efficacy of percutaneous edge-to-edge mitral repair between patients with functional and degenerative mitral regurgitation (MR). Evidence suggested the likely efficacy and safety of percutaneous edge-to-edge repair in both of these patient groups.

Methods

• All studies regarding MitraClip were searched from PubMed, EMBASE, Google scholar database and international meeting abstracts.
• This study did not include studies with <25 patients or where 1-year results were not delineated between MR aetiology.
• This study is registered with PROSPERO.

Results

• This meta-analysis (n=2615) included a total of 9 studies investigating the mid-term outcome of percutaneous edge-to-edge repair in patients with functional versus degenerative MR.
• Findings demonstrated no significant differences among groups in terms of patients with MR grade≤2 at 1 year (719/1304 vs 295/504; 58% vs 54%; risk ratio (RR) 1.12; 95% CI: 0.86 to 1.47; p=0.40), while there was a significantly lower rate of mitral valve re-intervention in patients with functional MR compared with those with degenerative MR (77/1770 vs 80/818; 4% vs 10%; RR 0.60; 95% CI: 0.38 to 0.97; p=0.04).
• Researchers found that 1-year mortality rate was 16% (408/2498) and similar among groups (RR 1.26; 95% CI: 0.90 to 1.77; p=0.18).
• In addition, they noted that functional MR group exhibited markedly higher percentage of patients in New York Heart Association class III/IV (234/1480 vs 49/583; 16% vs 8%; p<0.01) and re-hospitalisation for heart failure (137/605 vs 31/220; 23% vs 14%; p=0.03).
• Data reported no differences in terms of single leaflet device attachment (25/969 vs 20/464; 3% vs 4%; p=0.81) and device embolisation (no events reported in both groups) at 1 year.