Characteristics and outcomes of patients screened for transcatheter mitral valve implantation: 1‐year results from the CHOICE‐MI registry. (17th April 2022)

• Record Type: Journal Article
• Authors: Ben Ali, Walid; Ludwig, Sebastian; Duncan, Alison; Weimann, Jessica; Nickenig, Georg; Tanaka, Tetsu; Coisne, Augustin; Vincentelli, Andre; Makkar, Raj; Webb, John G.; Akodad, Mariama; Muller, David W.M.; Praz, Fabien; Wild, Mirjam G.; Hausleiter, Jörg; Goel, Sachin S.; von Ballmoos, Moritz Wyler; Denti, Paolo; Chehab, Omar; Redwood, Simon; Dahle, Gry; Baldus, Stephan; Adam, Matti; Ruge, Hendrik; Lange, Rüdiger; Kaneko, Tsuyoshi; Leroux, Lionel; Dumonteil, Nicolas; Tchetche, Didier; Treede, Hendrik; Flagiello, Michele; Obadia, Jean‐Francois; Walther, Thomas; Taramasso, Maurizio; Søndergaard, Lars; Bleiziffer, Sabine; Rudolph, Tanja K.; Fam, Neil; Kempfert, Joerg; Granada, Juan F.; Tang, Gilbert H.L.; von Bardeleben, Ralph Stephan; Conradi, Lenard; Modine, Thomas;
• Other Names: Kalbacher Daniel investigator.; Blankenberg Stefan investigator.; Koell Benedikt investigator.; Schofer Niklas investigator.; Westermann Dirk investigator.; Weber Marcel investigator.; Vogelhuber Johanna investigator.; Pontana François investigator.; Van Belle Eric investigator.; Yoon Sung‐Han investigator.; Chuang Anthony investigator.; Boone Robert H. investigator.; Jansz Paul investigator.; Song Ning investigator.; Hungerford Sara investigator.; Windecker Stephan investigator.; Reineke David investigator.; Reardon Michael investigator.; Kleiman Neal S. investigator.; Sala Alessandra investigator.; Agricola Eustachio investigator.; Maisano Francesco investigator.; Rajani Ronak investigator.; Prendergast Bernard investigator.; Rein Kjell A. investigator.; Koerber Maria I. investigator.; Ochs Laurin investigator.; Vitanova Keti investigator.; Erlebach Magdalena investigator.; Shah Pinak investigator.; Harloff Morgan investigator.; Bonnet Guillaume investigator.; Pernot Mathieu investigator.; Jonveaux Melchior investigator.; Kreidel Felix investigator.; Ruf Tobias investigator.; Pozzi Matteo investigator.; Dragulescu Razvan investigator.; Holubec Tomas investigator.; Strohschnitter Heike investigator.; Walther Claudia investigator.; Pozzoli Alberto investigator.; Wong Ivan investigator.; Friedrichs Kai investigator.; Peterson Mark investigator.; Unbehaun Axel investigator.; Kofler Markus investigator.;
• Is Part Of: European journal of heart failure. Volume 24:Number 5(2022)
• Page Start: 887
• Page End: 898
• Publication Date: 2022-04-17
• Subjects: Mitral regurgitation -- Transcatheter mitral valve implantation -- Transcatheter edge‐to‐edge repair -- Mitral valve surgery -- Medical therapy; Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1002/ejhf.2492
• Languages: English
• ISSNs: 1388-9842

Abstract

Abstract : Aims: Transcatheter mitral valve implantation (TMVI) represents a novel treatment option for patients with mitral regurgitation (MR) unsuitable for established therapies. The CHOICE‐MI registry aimed to investigate outcomes of patients undergoing screening for TMVI. Methods and results: From May 2014 to March 2021, patients with MR considered suboptimal candidates for transcatheter edge‐to‐edge repair (TEER) and at high risk for mitral valve surgery underwent TMVI screening at 26 centres. Characteristics and outcomes were investigated for patients undergoing TMVI and for TMVI‐ineligible patients referred to bailout‐TEER, high‐risk surgery or medical therapy (MT). The primary composite endpoint was all‐cause mortality or heart failure hospitalization after 1 year. Among 746 patients included (78.5 years, interquartile range [IQR] 72.0–83.0, EuroSCORE II 4.7% [IQR 2.7–9.7]), 229 patients (30.7%) underwent TMVI with 10 different dedicated devices. At 1 year, residual MR ≤1+ was present in 95.2% and the primary endpoint occurred in 39.2% of patients treated with TMVI. In TMVI‐ineligible patients ( n = 517, 69.3%), rates of residual MR ≤1+ were 37.2%, 100.0% and 2.4% after bailout‐TEER, high‐risk surgery and MT, respectively. The primary endpoint at 1 year occurred in 28.8% of patients referred to bailout‐TEER, in 42.9% of patients undergoing high‐risk surgery and in 47.9% of patients remaining on MT. Conclusion: This registry included the largest number of patients treated with TMVI to date. TMVI with 10 dedicated devices resulted in predictable MR elimination and sustained functional improvement at 1 year. In TMVI‐ineligible patients, bailout‐TEER and high‐risk surgery represented reasonable alternatives, while MT was associated with poor clinical and functional outcomes. Abstract : Results from the global CHOICE‐MI registry. CHOICE‐MI, CHoice of OptImal transCatheter trEatment for Mitral Insufficiency; HF, heart failure; MAC, mitral annulus calcification; MR, mitral regurgitation; MVPG, mitral valve pressure gradient; TEER, transcatheter edge‐to‐edge repair.