Wang TKM. Comparison of percutaneous MitraClip versus mitral valve surgery for severe mitral regurgitation: a meta-analysis: Mitraclip and mitral valve surgery meta-analysis.
ASIAINTERVENTION 2020;
6:77-84. [PMID:
34912990 PMCID:
PMC8525719 DOI:
10.4244/aij-d-19-00036]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 07/10/2020] [Indexed: 11/03/2023]
Abstract
AIMS
Mitral valve surgery (MVS) is the gold-standard treatment for severe symptomatic mitral regurgitation. Percutaneous mitral valve interventions such as the MitraClip procedure offer another dimension to its management particularly in high-risk patients. We meta-analysed the outcomes of MitraClip and MVS.
METHODS AND RESULTS
PubMed, MEDLINE, Embase, Cochrane and Scopus from 1980/01-2019/06 were searched for eligible studies. Data were extracted and pooled using random-effects models. After screening 959 studies and reviewing 21 full-text articles, nine studies totalling 640 MitraClip and 531 MVS (91% valve repair) procedures were included in the meta-analysis. MitraClip patients were older, with a higher prevalence of previous cardiac surgery, coronary disease and a higher EuroSCORE (all p<0.05) than MVS patients. Pooled operative mortality was similar for MitraClip, 3%, versus MVS, 5%, odds ratio (OR): 0.58, 95%, CI: 0.28-1.19, as well as at 1 year mortality, OR: 1.09, CI: 0.71-1.68 and 3-year mortality, OR: 1.08, CI: 0.72-0.163. MitraClip patients had higher rates of early and late significant mitral regurgitation (MR) and more cardiovascular readmissions, while MVS had higher rates of in-hospital bleeding and pacemaker implantation (all p<0.05).
CONCLUSIONS
MitraClip patients had a higher baseline risk than MVS, but there were no significant differences in short- and long-term mortality. MitraClip patients had higher rates of cardiovascular admissions and significant MR post-operatively, while MVS patients had more procedural complications.
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