Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis
<p dir="ltr">This systematic review and meta-analysis aimed to investigate whether percutaneous mitral valve repair (PMVr) using MitraClip was more effective than surgery or medical therapy for long-term morbidity and mortality. We searched MEDLINE, EMBASE, and CENTRAL (Cochrane Libr...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | , , |
| Published: |
2023
|
| Subjects: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1864513538544893952 |
|---|---|
| author | Rasha Kaddoura (12506936) |
| author2 | Sanket Bhattarai (17430909) Dina Abushanab (10696501) Mohammed Al-Hijji (4050934) |
| author2_role | author author author |
| author_facet | Rasha Kaddoura (12506936) Sanket Bhattarai (17430909) Dina Abushanab (10696501) Mohammed Al-Hijji (4050934) |
| author_role | author |
| dc.creator.none.fl_str_mv | Rasha Kaddoura (12506936) Sanket Bhattarai (17430909) Dina Abushanab (10696501) Mohammed Al-Hijji (4050934) |
| dc.date.none.fl_str_mv | 2023-09-21T12:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.amjcard.2023.08.097 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Percutaneous_Mitral_Valve_Repair_for_Secondary_Mitral_Regurgitation_A_Systematic_Review_and_Meta-Analysis/24607098 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Pharmacology and pharmaceutical sciences edge-to-edge functional mitral regurgitation mitral insufficiency optimal medical therapy percutaneous repair transcatheter repair |
| dc.title.none.fl_str_mv | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <p dir="ltr">This systematic review and meta-analysis aimed to investigate whether percutaneous mitral valve repair (PMVr) using MitraClip was more effective than surgery or medical therapy for long-term morbidity and mortality. We searched MEDLINE, EMBASE, and CENTRAL (Cochrane Library) databases to identify relevant studies that recruited adult patients with functional or secondary mitral valve regurgitation who underwent PMVr with MitraClip implantation using appropriate search terms and Boolean operators. The odds ratios (ORs) were pooled using the random-effects model. A total of 14 studies recruiting 2,593 patients were included. Within 12 months of follow-up, patients who underwent PMVr did not maintain mitral valve regurgitation grade 2+ (OR 0.22, 95% confidence interval [CI] 0.12 to 0.41, p <0.0001, I<sup>2</sup> = 0.0%, p = 0.52) or symptom-free heart failure (OR 0.47, 95% CI 0.29 to 0.77, p = 0.0028, I<sup>2</sup> = 0.0%, p = 0.66) compared with their surgical counterparts. Patients were more likely to be rehospitalized for heart failure (OR 2.79, 95% CI 1.54 to 5.05, p = 0.0007, I<sup>2</sup> = 0.0%, p = 0.51). However, there was no difference between the groups in terms of all-cause or cardiovascular mortality. Whereas, in comparison with medical therapy, PMVr significantly reduced all-cause mortality at 12 and ≥24 months of follow-up (OR 0.41, 95% CI 0.24, 0.69, p = 0.0009, I<sup>2</sup> = 32%, p = 0.23 and OR 0.55, 95% CI 0.40, 0.75, p = 0.0002, I<sup>2</sup> = 0.0%, p = 0.45, respectively). In conclusion, there was no difference in all-cause death at 12 or 24 months of follow-up between PMVr and the surgical approach, but the durability of valvular repair was inferior with PMVr. In comparison with medical therapy, there was a significant reduction in mortality with PMVr.</p><h2>Other Information</h2><p dir="ltr">Published in: The American Journal of Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.amjcard.2023.08.097" target="_blank">https://dx.doi.org/10.1016/j.amjcard.2023.08.097</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_e1de30a7a13b65c17a6451ddd44929c4 |
| identifier_str_mv | 10.1016/j.amjcard.2023.08.097 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/24607098 |
| publishDate | 2023 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-AnalysisRasha Kaddoura (12506936)Sanket Bhattarai (17430909)Dina Abushanab (10696501)Mohammed Al-Hijji (4050934)Biomedical and clinical sciencesCardiovascular medicine and haematologyPharmacology and pharmaceutical sciencesedge-to-edgefunctional mitral regurgitationmitral insufficiencyoptimal medical therapypercutaneous repairtranscatheter repair<p dir="ltr">This systematic review and meta-analysis aimed to investigate whether percutaneous mitral valve repair (PMVr) using MitraClip was more effective than surgery or medical therapy for long-term morbidity and mortality. We searched MEDLINE, EMBASE, and CENTRAL (Cochrane Library) databases to identify relevant studies that recruited adult patients with functional or secondary mitral valve regurgitation who underwent PMVr with MitraClip implantation using appropriate search terms and Boolean operators. The odds ratios (ORs) were pooled using the random-effects model. A total of 14 studies recruiting 2,593 patients were included. Within 12 months of follow-up, patients who underwent PMVr did not maintain mitral valve regurgitation grade 2+ (OR 0.22, 95% confidence interval [CI] 0.12 to 0.41, p <0.0001, I<sup>2</sup> = 0.0%, p = 0.52) or symptom-free heart failure (OR 0.47, 95% CI 0.29 to 0.77, p = 0.0028, I<sup>2</sup> = 0.0%, p = 0.66) compared with their surgical counterparts. Patients were more likely to be rehospitalized for heart failure (OR 2.79, 95% CI 1.54 to 5.05, p = 0.0007, I<sup>2</sup> = 0.0%, p = 0.51). However, there was no difference between the groups in terms of all-cause or cardiovascular mortality. Whereas, in comparison with medical therapy, PMVr significantly reduced all-cause mortality at 12 and ≥24 months of follow-up (OR 0.41, 95% CI 0.24, 0.69, p = 0.0009, I<sup>2</sup> = 32%, p = 0.23 and OR 0.55, 95% CI 0.40, 0.75, p = 0.0002, I<sup>2</sup> = 0.0%, p = 0.45, respectively). In conclusion, there was no difference in all-cause death at 12 or 24 months of follow-up between PMVr and the surgical approach, but the durability of valvular repair was inferior with PMVr. In comparison with medical therapy, there was a significant reduction in mortality with PMVr.</p><h2>Other Information</h2><p dir="ltr">Published in: The American Journal of Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.amjcard.2023.08.097" target="_blank">https://dx.doi.org/10.1016/j.amjcard.2023.08.097</a></p>2023-09-21T12:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.amjcard.2023.08.097https://figshare.com/articles/journal_contribution/Percutaneous_Mitral_Valve_Repair_for_Secondary_Mitral_Regurgitation_A_Systematic_Review_and_Meta-Analysis/24607098CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/246070982023-09-21T12:00:00Z |
| spellingShingle | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis Rasha Kaddoura (12506936) Biomedical and clinical sciences Cardiovascular medicine and haematology Pharmacology and pharmaceutical sciences edge-to-edge functional mitral regurgitation mitral insufficiency optimal medical therapy percutaneous repair transcatheter repair |
| status_str | publishedVersion |
| title | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis |
| title_full | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis |
| title_fullStr | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis |
| title_short | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis |
| title_sort | Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Pharmacology and pharmaceutical sciences edge-to-edge functional mitral regurgitation mitral insufficiency optimal medical therapy percutaneous repair transcatheter repair |