Echocardiographic Outcomes from Transcatheter Edge-to-Edge Repair for Degenerative Mitral Regurgitation in Prohibitive Surgical Risk Patients - JIMG May 2024-Article: Echocardiographic Outcomes from Transcatheter Edge-to-Edge Repair for Degenerative Mitral Regurgitation in Prohibitive Surgical Risk Patients

Article: Echocardiographic Outcomes from Transcatheter Edge-to-Edge Repair for Degenerative Mitral Regurgitation in Prohibitive Surgical Risk Patients

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The document summarizes the CLASP IID trial outcomes focusing on transcatheter mitral edge-to-edge repair (M-TEER) for degenerative mitral regurgitation (DMR), comparing the PASCAL and MitraClip systems. Results indicate successful mitral regurgitation reduction post-procedure, with sustained effects at 6 months. Patients with smaller flail gaps and those treated with PASCAL had better sustained outcomes. Left ventricular improvements, reduced valve gradient, and pulmonary pressure were observed. Achieving MR reduction to #1+ was highlighted as a successful benchmark for M-TEER, emphasizing personalized treatment based on patient characteristics. The study discussed the impact of mitral annular calcification (MAC) and the necessity for refined echocardiographic methodologies. The PASCAL system was suggested to lead to more sustained MR reduction than MitraClip, possibly due to device design. Considerations such as flail gap size and MAC were emphasized for patient selection and procedural planning. The document stresses the ongoing evolution of echocardiographic assessment and the importance of achieving optimal outcomes like MR #1+ in DMR cases. Larger studies and longer follow-ups were suggested to validate the findings further, with implications directed towards advancing M-TEER procedures and improving patient care in DMR cases.

Keywords

CLASP IID trial

transcatheter mitral edge-to-edge repair

M-TEER

degenerative mitral regurgitation

PASCAL system

MitraClip system

mitral regurgitation reduction

sustained outcomes

mitral annular calcification

echocardiographic assessment