Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair: Mid-Term Outcomes From the CUTTING-EDGE International Registry
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Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair: Mid-Term Outcomes From the CUTTING-EDGE International Registry. / Kaneko, Tsuyoshi; Hirji, Sameer; Zaid, Syed; Lange, Rudiger; Kempfert, Jörg; Conradi, Lenard; Hagl, Christian; Borger, Michael A; Taramasso, Maurizio; Nguyen, Tom C; Ailawadi, Gorav; Shah, Ashish S; Smith, Robert L; Anselmi, Amedeo; Romano, Matthew A; Ben Ali, Walid; Ramlawi, Basel; Grubb, Kendra J; Robinson, Newell B; Pirelli, Luigi; Chu, Michael W A; Andreas, Martin; Obadia, Jean-Francois; Gennari, Marco; Garatti, Andrea; Tchetche, Didier; Nazif, Tamim M; Bapat, Vinayak N; Modine, Thomas; Denti, Paolo; Tang, Gilbert H L; CUTTING-EDGE Investigators.
In: JACC-CARDIOVASC INTE, Vol. 14, No. 18, 27.09.2021, p. 2010-2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair: Mid-Term Outcomes From the CUTTING-EDGE International Registry
AU - Kaneko, Tsuyoshi
AU - Hirji, Sameer
AU - Zaid, Syed
AU - Lange, Rudiger
AU - Kempfert, Jörg
AU - Conradi, Lenard
AU - Hagl, Christian
AU - Borger, Michael A
AU - Taramasso, Maurizio
AU - Nguyen, Tom C
AU - Ailawadi, Gorav
AU - Shah, Ashish S
AU - Smith, Robert L
AU - Anselmi, Amedeo
AU - Romano, Matthew A
AU - Ben Ali, Walid
AU - Ramlawi, Basel
AU - Grubb, Kendra J
AU - Robinson, Newell B
AU - Pirelli, Luigi
AU - Chu, Michael W A
AU - Andreas, Martin
AU - Obadia, Jean-Francois
AU - Gennari, Marco
AU - Garatti, Andrea
AU - Tchetche, Didier
AU - Nazif, Tamim M
AU - Bapat, Vinayak N
AU - Modine, Thomas
AU - Denti, Paolo
AU - Tang, Gilbert H L
AU - CUTTING-EDGE Investigators
N1 - Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2021/9/27
Y1 - 2021/9/27
N2 - OBJECTIVES: The aim of this study was to determine clinical and echocardiographic characteristics, mechanisms of failure, and outcomes of mitral valve (MV) surgery after transcatheter edge-to-edge repair (TEER).BACKGROUND: Although >100,000 mitral TEER procedures have been performed worldwide, longitudinal data on MV surgery after TEER are lacking.METHODS: Data from the multicenter, international CUTTING-EDGE registry were retrospectively analyzed. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 9.0 months (interquartile range [IQR]: 1.2-25.7 months) after MV surgery, and follow-up was 96.1% complete at 30 days and 81.1% complete at 1 year.RESULTS: From July 2009 to July 2020, 332 patients across 34 centers underwent MV surgery after TEER. The mean age was 73.8 ± 10.1 years, median Society of Thoracic Surgeons risk for MV repair at initial TEER was 4.0 (IQR: 2.3-7.3), and primary/mixed and secondary mitral regurgitation were present in 59.0% and 38.5%, respectively. The median interval from TEER to surgery was 3.5 months (IQR: 0.5-11.9 months), with overall median Society of Thoracic Surgeons risk of 4.8% for MV replacement (IQR: 2.8%-8.4%). The primary indication for surgery was recurrent mitral regurgitation (33.5%), and MV replacement and concomitant tricuspid surgery were performed in 92.5% and 42.2% of patients, respectively. The 30-day and 1-year mortality rates were 16.6% and 31.3%, respectively. On Kaplan-Meier analysis, the actuarial estimates of mortality were 24.1% at 1 year and 31.7% at 3 years after MV surgery.CONCLUSIONS: In this first report of the CUTTING-EDGE registry, the mortality and morbidity risks of MV surgery after TEER were not negligible, and only <10% of patients underwent MV repair. These registry data provide valuable insights for further research to improve these outcomes.
AB - OBJECTIVES: The aim of this study was to determine clinical and echocardiographic characteristics, mechanisms of failure, and outcomes of mitral valve (MV) surgery after transcatheter edge-to-edge repair (TEER).BACKGROUND: Although >100,000 mitral TEER procedures have been performed worldwide, longitudinal data on MV surgery after TEER are lacking.METHODS: Data from the multicenter, international CUTTING-EDGE registry were retrospectively analyzed. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 9.0 months (interquartile range [IQR]: 1.2-25.7 months) after MV surgery, and follow-up was 96.1% complete at 30 days and 81.1% complete at 1 year.RESULTS: From July 2009 to July 2020, 332 patients across 34 centers underwent MV surgery after TEER. The mean age was 73.8 ± 10.1 years, median Society of Thoracic Surgeons risk for MV repair at initial TEER was 4.0 (IQR: 2.3-7.3), and primary/mixed and secondary mitral regurgitation were present in 59.0% and 38.5%, respectively. The median interval from TEER to surgery was 3.5 months (IQR: 0.5-11.9 months), with overall median Society of Thoracic Surgeons risk of 4.8% for MV replacement (IQR: 2.8%-8.4%). The primary indication for surgery was recurrent mitral regurgitation (33.5%), and MV replacement and concomitant tricuspid surgery were performed in 92.5% and 42.2% of patients, respectively. The 30-day and 1-year mortality rates were 16.6% and 31.3%, respectively. On Kaplan-Meier analysis, the actuarial estimates of mortality were 24.1% at 1 year and 31.7% at 3 years after MV surgery.CONCLUSIONS: In this first report of the CUTTING-EDGE registry, the mortality and morbidity risks of MV surgery after TEER were not negligible, and only <10% of patients underwent MV repair. These registry data provide valuable insights for further research to improve these outcomes.
KW - Aged
KW - Aged, 80 and over
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Humans
KW - Middle Aged
KW - Mitral Valve/diagnostic imaging
KW - Mitral Valve Insufficiency/diagnostic imaging
KW - Registries
KW - Retrospective Studies
KW - Treatment Outcome
U2 - 10.1016/j.jcin.2021.07.029
DO - 10.1016/j.jcin.2021.07.029
M3 - SCORING: Journal article
C2 - 34556275
VL - 14
SP - 2010
EP - 2021
JO - JACC-CARDIOVASC INTE
JF - JACC-CARDIOVASC INTE
SN - 1936-8798
IS - 18
ER -