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Safety and Efficacy of Transcatheter Edge-To-Edge Repair in Atrial Functional Mitral Regurgitation
Session:
SESSÃO DE POSTERS 31 - VALVULOPATIA MITRAL E TRICÚSPIDE - DIAGNÓSTICO E INTERVENÇÃO VALVULAR
Speaker:
Mafalda de Oliveira Griné
Congress:
CPC 2025
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Mafalda Griné; Rita Bertão Ventura; Diogo Matias; Diana de Campos; Luísa Rocha; Tomás Carlos; Bernardo Resende; Manuel Oliveira-Santos; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Background:</strong> The optimal treatment strategy for atrial functional mitral regurgitation (AFMR) remains unclear. We sought to evaluate the safety and efficacy of mitral transcatheter edge-to-edge repair (M-TEER) in this patient subset.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods:</strong> We conducted a single-center retrospective analysis of consecutive M-TEER cases from November 2018 to November 2023. Patients were divided into two groups: those with and without AFMR (non-AFMR), according to baseline echocardiographic characteristics. Clinical and echocardiographic outcomes up to one year were analyzed.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong>: Of the total of 93 patients that underwent M-TEER during the study period, 29 (31%) met AMFR criteria. AFMR patients were older (median age of 80 years [interquartile range (IQR): 77-84] vs 76 years [IQR: 68-82] in the non-AFMR group; p=0.01) and displayed greater left atrial volume (74 mL/m<sup>2</sup> (IQR: 50-98) vs 58 mL/m<sup>2</sup> (47-72), p=0.047) and left ventricular ejection fraction (55% (IQR: 53-58) vs 42% (IQR: 31, 57), p=0.002). Procedural success was achieved in 96.8% of cases, with no difference between groups (p=0.8). There was one device detachment at 12 months. MR grade <span style="font-size:14pt">=</span>II was achieved in 100% and 90.2% at 3 months (p=0.5) and in 86.2% and 82.8% at 1 year (p=0.8) in patients with AFMR and non-AFMR, respectively. All-cause mortality and heart failure hospitalization rates at 1 year did not differ between groups (6.9% vs 6.3%, p=0.7; 17.2% vs 15.6%, p=0.3, respectively). Periprocedural complications were infrequent (6.5%) and rarely severe (3 bleeding events, 2 atrial arrythmias, 1 acute heart failure decompensation). There were no periprocedural deaths nor urgent conversions to open heart surgery.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion:</strong> M-TEER was equally safe and effective in AFMR and non-AFMR. Considering contemporary evidence, M-TEER appears to be a viable treatment strategy for AFMR.</span></span></span></p>
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