Efficacy and safety of trans-catheter repair devices for mitral regurgitation: A systematic review and meta-analysis. in International journal of cardiology / Int J Cardiol. 2024 Sep 15;411:132245. doi: 10.1016/j.ijcard.2024.132245. Epub 2024 Jun 6.
2024
AOU Novara
Tipo pubblicazione
Systematic Review
Autori/Collaboratori (6)Vedi tutti...
D'Amario D
Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Division of Cardiology, AOU Maggiore della Carità, Novara, Italy.
Laborante R
Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Mennuni M
Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Division of Cardiology, AOU Maggiore della Carità, Novara, Italy.
et alii...
Abstract
BACKGROUND: Several repair strategies emerged as possible treatment for severe mitral regurgitation (MR). A systematic review and meta-analysis was performed to compare the different percutaneous mitral valve repair approaches. METHODS: PubMed and Scopus electronic databases were scanned for eligible studies until December 11th, 2023. Clinical efficacy endpoints were all-cause mortality, major adverse cardiovascular events, and post-procedural NYHA functional class <3; the echocardiographic efficacy endpoint was a post-intervention residual MR less than moderate. Safety endpoints and procedural outcome measures were also assessed. RESULTS: Eleven studies were included: 8 [N = 1662 patients, mean follow-up (FUP) 294 days] compared MitraClip® vs Pascal® device, 2 (N = 195 patients) MitraClip® vs Carillon® and 1 study (N = 186 patients) evaluated MitraClip® against Cardioband®. The Pascal®-treated group had lower MR degree compared to the MitraClip®-treated group, without difference in post-intervention mean trans-mitral gradient and in clinical and safety endpoints. A longer procedure time was observed in the Pascal® group, albeit with a lower average number of implanted devices per procedure. The two studies comparing MitraClip® and Carillon® were inconsistent in terms of both efficacy and safety outcomes, while the study evaluating MitraClip® vs Cardioband® showed that the latter might confer a significant clinical benefit, with a similar reduction in MR. CONCLUSIONS: Pascal® is as safe and clinically effective as MitraClip® in treating patients with MR, with an apparent greater reduction in the magnitude of residual valve insufficiency over the long term. Data on Cardioband® and Carillon® are not robust enough to draw conclusions from the use of such devices.
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PMID : 38851540
DOI : 10.1016/j.ijcard.2024.132245
Keywords
Mitral Valve Insufficiency/surgery/diagnostic imaging; Humans; Treatment Outcome; Cardiac Catheterization/methods/instrumentation; Heart Valve Prosthesis Implantation/instrumentation/methods/adverse effects; MitraClip; Mitral regurgitation; Pascal; Percutaneous repair;