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Comparison of Real-World Mitral TEER Outcomes with COAPT and MITRA-FR: A Single-Center Analysis
Session:
SESSÃO DE POSTERS 54 - INTERVENÇÃO MITRAL PERCUTÂNEA E CIRURGIA CARDÍACA
Speaker:
Marta Leite
Congress:
CPC 2025
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Marta Leite; Fábio Nunes; Inês Neves; André Lobo; Diogo Ferreira; Pedro Teixeira; Gustavo Pires-Morais; Bruno Melica; José Ribeiro; Pedro Braga; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Heart failure patients with severe mitral regurgitation present complex management challenges. Percutaneous edge-to-edge mitral valve repair (Mitral TEER) has become an important therapeutic option for these patients. Completing our 100th Mitral TEER procedure marks a significant milestone in optimizing care for this population at our center.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim:</strong> This study aims to profile heart failure patients with severe mitral regurgitation treated with Mitral TEER at our institution. By analyzing demographic, clinical, and echocardiographic characteristics, we compare our findings with the COAPT and MITRA-FR trials to explore shared patterns and distinct differences.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> We performed a retrospective analysis of 100 heart failure patients who underwent Mitral TEER between 2014 and 2020 at our center. Data were collected on demographics, comorbidities, and echocardiographic parameters. Comparative analyses were conducted against relevant metrics reported in the COAPT and MITRA-FR trials.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results: </strong>Among the study cohort, 58% were male and 42% female, with a median age of 76.5 years. Frequent comorbidities included arterial hypertension (69%), diabetes mellitus (36%), and atrial fibrillation/flutter (71%). Severe mitral regurgitation (Grade IV) was observed in 72%, predominantly of functional etiology (70%), with ischemic mitral regurgitation representing 43%. Most patients were in NYHA Class II (59%).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Comparatively, the left ventricle end-diastolic volume index (LVEDVi) in our population (120 mL/m²) was lower than in the MITRA-FR trial (135 mL/m²) but exceeded COAPT values (101 mL/m²). The effective regurgitant orifice area (EROA) was similar to COAPT (42 mm² vs. 41 mm²) and larger than MITRA-FR (31 mm²). Additional findings included a median left ventricular ejection fraction of 40%, tricuspid annular plane systolic excursion (TAPSE) of 18.0 mm, and indexed left atrial volume of 57.0 mL/m². </span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Survival rates at 12 and 36 months were 89% and 47%, respectively.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion: </strong>This study characterizes the clinical and echocardiographic profiles of patients undergoing Mitral TEER at our center and compares outcomes with the COAPT and MITRA-FR trials. Our population aligns closely with COAPT in terms of EROA criteria but demonstrates a larger left ventricular chamber size. These findings provide a meaningful contribution to understanding Mitral TEER outcomes in diverse clinical settings.</span></span></p>
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