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Transcatheter Mitral Valve Repair Benefits Some With Heart Failure

For patients with secondary mitral regurgitation who remain symptomatic despite medical therapy

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FRIDAY, Oct. 19, 2018 (HealthDay News) -- Transcatheter mitral-valve repair results in a lower rate of hospitalization and lower all-cause mortality than medical therapy alone among patients with heart failure and moderate-to-severe secondary mitral regurgitation who remain symptomatic despite the use of guideline-directed medical therapy, according to a study published online Sept. 23 in the New England Journal of Medicine.

Gregg W. Stone, M.D., from the Columbia University Medical Center in New York City, and colleagues enrolled 614 patients with heart failure at 78 sites in the United States and Canada. Patients with heart failure and moderate-to-severe or severe secondary mitral regurgitation who remained symptomatic despite using maximal doses of guideline-directed medical therapy were randomized to transcatheter mitral-valve repair plus medical therapy (302 patients) or medical therapy alone (312 patients).

The researchers found that the annualized rate of all hospitalizations for heart failure within 24 months was 35.8 and 67.9 percent per patient-year in the device group and the control group, respectively (hazard ratio, 0.53). At 12 months, the rate of freedom from device-related complications was 96.6 percent. Death from any cause within 24 months occurred in 29.1 and 46.1 percent of patients in the device group and control group, respectively (hazard ratio, 0.62).

"Transcatheter mitral-valve repair resulted in a lower rate of hospitalization for heart failure and lower all-cause mortality within 24 months of follow-up than medical therapy alone," the authors write.

Several authors disclosed financial ties to pharmaceutical and medical device companies, including Abbott, which funded the study.

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