Title : Outcomes of transcatheter edge-to-edge repair vs surgical repair in secondary mitral regurgitation - A meta-analysis
Abstract:
Introduction: Current treatment recommendations for secondary mitral regurgitation (MR) include transcatheter edge-to-edge repair (TEER) and mitral valve surgery. Surgical repair (SR) has been the traditional approach but TEER has emerged as a less invasive alternative. Currently, not enough data is available, comparing the outcomes of TEER and SR for secondary MR.
Purpose: To compare major adverse events and mortality rate between TEER and SR procedures for secondary mitral regurgitation.
Method: Pubmed database was searched using keywords “transcatheter vs surgery” AND “secondary mitral regurgitation” from 2015 to 2024. All the relevant observational studies were included following PRISMA guidelines. The adverse outcomes compared include all-cause mortality, worsening of HF symptoms and reintervention. All the cases of secondary MR due to heart failure, post-MI and in the setting of liver disease were included in the analysis.
Results: Four relevant observational studies (N= 1467) were included in our study. Out of the N= 1467 secondary MR patients, N= 419 patients underwent TEER and N= 1048 patients underwent SR. The pooled analysis revealed a statistically significant association between TEER for secondary MR and lower adverse outcomes as compared to SR [Odds Ratio (OR)= 0.45, 95% CI: 0.02 - 0.87, p = 0.04].
Conclusion: This systematic review shows that TEER is a promising option for patients with secondary MR, offering a less invasive approach with favorable outcomes. Large randomized studies are required to confirm these results.
