Percutaneous mitral valve repair for secondary mitral valve regurgitation: A systematic review and meta-analysis. 2020

Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
Department of Critical Care, St John's Medical college hospital, Bengaluru, Karnataka, India.

The first two randomized control trials (RCTs) studying the role of MitraClip in patients with secondary mitral regurgitation (MR) had antagonizing results. We, therefore, performed an updated meta-analysis of RCTs and propensity score-matched observational studies investigating the role of MitraClips in patients with secondary MR. A novel method of Kaplan Meier Curve reconstruction from derived individual patient data will be used to compare the survival probability of control groups in COAPT and MITRA HF trail, and hence, access inter-study heterogeneity. Medline and Cochrane databases was used for systematic search. We used the Mantel-Haenszel method with a random-effect model to calculate risk ratio (RR) with 95% confidence interval (CI) and inverse variance method with a random-effect model to calculate the mean difference (MD) with 95% confidence interval (CI). We used a fixed-effect approach for meta-regression. MitraClip reduced the risk of all-cause mortality [RR: 0.72, CI: 0.55-0.95, P value = 0.02, I2 = 55%, χ2P-value = 0.08] and readmission [RR: 0.62, CI: 0.42-0.92, P value = 0.02, I2 = 90%, χ2P-value<0.01] at two years follow-up. There was no effect of MitraClip on change in cardiovascular mortality and 6 m walking distance at 12 months follow-up. Meta-regression indicated left ventricular end diastolic volume and age among the factors affecting outcomes. Reconstructed Kaplan Meier curves confirmed considerable heterogeneity among patients randomized in MITRA HF and COAPT trial. The present meta-analysis confirms the beneficial role of percutaneous mitral valve repair in patients with secondary MR. However, all the results were associated with considerable heterogeneity.

UI MeSH Term Description Entries
D008943 Mitral Valve The valve between the left atrium and left ventricle of the heart. Bicuspid Valve,Bicuspid Valves,Mitral Valves,Valve, Bicuspid,Valve, Mitral,Valves, Bicuspid,Valves, Mitral
D008944 Mitral Valve Insufficiency Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation. Mitral Incompetence,Mitral Regurgitation,Mitral Valve Incompetence,Mitral Insufficiency,Mitral Valve Regurgitation,Incompetence, Mitral,Incompetence, Mitral Valve,Insufficiency, Mitral,Insufficiency, Mitral Valve,Regurgitation, Mitral,Regurgitation, Mitral Valve,Valve Incompetence, Mitral,Valve Insufficiency, Mitral,Valve Regurgitation, Mitral
D006348 Cardiac Surgical Procedures Surgery performed on the heart. Cardiac Surgical Procedure,Heart Surgical Procedure,Heart Surgical Procedures,Procedure, Cardiac Surgical,Procedure, Heart Surgical,Procedures, Cardiac Surgical,Procedures, Heart Surgical,Surgical Procedure, Cardiac,Surgical Procedure, Heart,Surgical Procedures, Cardiac,Surgical Procedures, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D019918 Heart Valve Prosthesis Implantation Surgical insertion of synthetic material to repair injured or diseased heart valves. Implantation, Heart Valve Prosthesis

Related Publications

Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
November 2023, The American journal of cardiology,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
January 2022, Frontiers in cardiovascular medicine,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
July 2020, Cardiovascular revascularization medicine : including molecular interventions,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
January 2019, Journal of interventional cardiology,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
February 2003, Journal of interventional cardiology,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
June 2022, Journal of cardiac surgery,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
June 2021, Journal of cardiothoracic surgery,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
June 2017, Journal of thoracic disease,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
May 2019, The New England journal of medicine,
Ashish Kumar, and Jaafar Al-Khafaji, and Mariam Shariff, and Igor Pedreira Vaz, and Devina Adalja, and Rajkumar Doshi
May 2019, The New England journal of medicine,
Copied contents to your clipboard!