E-41 | Echocardiographic Predictors of Suboptimal Transcatheter Mitral Valve Repair in Patients with Secondary Mitral Regurgitation

Abstract

BackgroundResidual mitral regurgitation (MR) following mitral valve transcatheter edge-to-edge repair (TEER) is associated with worse outcomes. This study sought to identify echocardiographic predictors of suboptimal MR reduction following TEER in patients with secondary MR.MethodsIn this retrospective single-center study, we identified all patients with secondary MR who underwent TEER between 2016-2021. Pre- and intra-procedural transesophageal echocardiographic (TEE) images were abstracted. The primary outcome was suboptimal MR reduction, defined as ≥ 2+ MR on post-procedural TEE. The association of preoperative echocardiographic parameters with the primary outcome was tested via univariate and multivariate analyses.Results65 patients (69 ± 15 years; 49% female) with secondary MR underwent TEER with MitraClipTM. The average left ventricular ejection fraction and NYHA class were 35% and III, respectively. Technical success (≤ 2+ MR post-TEER) was achieved in 94%. Suboptimal MR reduction was observed in 38% of patients. Independent predictors of suboptimal MR reduction included bicommissural MR [odds ratio (OR): 7.95, 95% confidence interval (CI): 1.50 – 42.3, p = 0.02], 2D-APd [OR: 6.46, CI: 1.85 – 22.51 per cm, p < 0.01], and MVA:LVEDV ratio [OR: 0.69, CI: 0.50 – 0.93 per mm2/mL, p = 0.02] (Table).ConclusionsDisclosuresO. Aksoy: Edwards Lifesciences: Proctor; R. V. Parikh: Abbott: Consulting; M. C. Press: Abbott: Proctor; J. E. Labin Nothing to disclose. D. M. Tehrani Nothing to disclose. P. Lai Nothing to disclose. E. H. Yang Nothing to disclose. G. Lluri Nothing to disclose. A. Nsair Nothing to disclose. BackgroundResidual mitral regurgitation (MR) following mitral valve transcatheter edge-to-edge repair (TEER) is associated with worse outcomes. This study sought to identify echocardiographic predictors of suboptimal MR reduction following TEER in patients with secondary MR. Residual mitral regurgitation (MR) following mitral valve transcatheter edge-to-edge repair (TEER) is associated with worse outcomes. This study sought to identify echocardiographic predictors of suboptimal MR reduction following TEER in patients with secondary MR. MethodsIn this retrospective single-center study, we identified all patients with secondary MR who underwent TEER between 2016-2021. Pre- and intra-procedural transesophageal echocardiographic (TEE) images were abstracted. The primary outcome was suboptimal MR reduction, defined as ≥ 2+ MR on post-procedural TEE. The association of preoperative echocardiographic parameters with the primary outcome was tested via univariate and multivariate analyses. In this retrospective single-center study, we identified all patients with secondary MR who underwent TEER between 2016-2021. Pre- and intra-procedural transesophageal echocardiographic (TEE) images were abstracted. The primary outcome was suboptimal MR reduction, defined as ≥ 2+ MR on post-procedural TEE. The association of preoperative echocardiographic parameters with the primary outcome was tested via univariate and multivariate analyses. Results65 patients (69 ± 15 years; 49% female) with secondary MR underwent TEER with MitraClipTM. The average left ventricular ejection fraction and NYHA class were 35% and III, respectively. Technical success (≤ 2+ MR post-TEER) was achieved in 94%. Suboptimal MR reduction was observed in 38% of patients. Independent predictors of suboptimal MR reduction included bicommissural MR [odds ratio (OR): 7.95, 95% confidence interval (CI): 1.50 – 42.3, p = 0.02], 2D-APd [OR: 6.46, CI: 1.85 – 22.51 per cm, p < 0.01], and MVA:LVEDV ratio [OR: 0.69, CI: 0.50 – 0.93 per mm2/mL, p = 0.02] (Table). 65 patients (69 ± 15 years; 49% female) with secondary MR underwent TEER with MitraClipTM. The average left ventricular ejection fraction and NYHA class were 35% and III, respectively. Technical success (≤ 2+ MR post-TEER) was achieved in 94%. Suboptimal MR reduction was observed in 38% of patients. Independent predictors of suboptimal MR reduction included bicommissural MR [odds ratio (OR): 7.95, 95% confidence interval (CI): 1.50 – 42.3, p = 0.02], 2D-APd [OR: 6.46, CI: 1.85 – 22.51 per cm, p < 0.01], and MVA:LVEDV ratio [OR: 0.69, CI: 0.50 – 0.93 per mm2/mL, p = 0.02] (Table). Conclusions DisclosuresO. Aksoy: Edwards Lifesciences: Proctor; R. V. Parikh: Abbott: Consulting; M. C. Press: Abbott: Proctor; J. E. Labin Nothing to disclose. D. M. Tehrani Nothing to disclose. P. Lai Nothing to disclose. E. H. Yang Nothing to disclose. G. Lluri Nothing to disclose. A. Nsair Nothing to disclose. O. Aksoy: Edwards Lifesciences: Proctor; R. V. Parikh: Abbott: Consulting; M. C. Press: Abbott: Proctor; J. E. Labin Nothing to disclose. D. M. Tehrani Nothing to disclose. P. Lai Nothing to disclose. E. H. Yang Nothing to disclose. G. Lluri Nothing to disclose. A. Nsair Nothing to disclose.