IMR Press / RCM / Volume 23 / Issue 10 / DOI: 10.31083/j.rcm2310332
Open Access Systematic Review
Transcatheter Mitral Valve Repair for Failed Surgical Mitral Valve Repair: A Systematic Review and Meta-Analysis
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1 Department of Cardiovascular Surgery, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Chinese Academy of Medical Science, 100037 Beijing, China
*Correspondence: zhongzhaoji@sina.com (Zhaoji Zhong)
Academic Editor: Antonio Mangieri
Rev. Cardiovasc. Med. 2022, 23(10), 332; https://doi.org/10.31083/j.rcm2310332
Submitted: 28 June 2022 | Revised: 23 August 2022 | Accepted: 29 August 2022 | Published: 28 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objectives: To assess the outcomes of transcatheter mitral valve repair (TMVr) for failed previous surgical mitral valve repair (MVr). Methods: We searched Pubmed, Embase, and Cochrane Library databases for studies that reported the outcomes of TMVr for failed initial surgical MVr. Data were extracted by 2 independent investigators and subjected to meta-analysis. The 95% confidence interval (CI) was calculated for preoperative demographics, peri-operative outcomes, and follow-up outcomes using binary and continuous data from single-arm studies. Results: Eight single-arm studies were included, with a total of 212 patients, and mean follow-up ranged from 1.0 to 15.9 months. The pooled rate of residual procedural mitral regurgitation mild was 76% (95% CI: 67%~84%; I2 = 0%; 7 studies, 199 patients). During follow-up, mitral regurgitation mild was found in 68% of patients (95% CI: 52%~82%; I2 = 57%; 6 studies, 147 patients). Follow-up survival was 94% (95% CI: 88%~98%; I2 = 0%; 7 studies, 196 patients). 83% patients (95% CI: 75%~89%; I2 = 47%; 6 studies, 148 patients) were in NYHA class I or II. Conclusions: TMVr for failed surgical MVr was safe and effective, which should be recommended in selected patients if technically feasible.

Keywords
mitral valve repair
failure
recurrence
transcatheter mitral valve repair
MitraClip
Neochord
Funding
Z201100005520005/Capital Science and Technology Program, Beijing
Figures
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