PMID- 33635244
OWN - NLM
STAT- MEDLINE
DCOM- 20210720
LR  - 20210720
IS  - 1522-6662 (Electronic)
IS  - 1098-3511 (Linking)
VI  - 24
IP  - 1
DP  - 2021 Feb 15
TI  - Comparison of Transcatheter Mitral-Valve Repair and Surgical Mitral-Valve Repair 
      in Elderly Patients with Mitral Regurgitation.
PG  - E108-E115
LID - 10.1532/hsf.3433 [doi]
AB  - PURPOSE: To summarize comparative studies of MitraClip versus surgical repair in 
      typical, real-world elderly patients with severe mitral regurgitation (MR) and 
      analyze the safety and effectiveness of these therapeutic options. METHODS: 
      PubMed, Medline, Embase, and Cochrane Controlled Register of Trials (CENTRAL) 
      were searched for comparative studies of transcatheter mitral-valve repair (TMVR) 
      versus surgical mitral-valve repair (SMVR) in elderly patients with severe MR 
      from January 2000 to June 2020. Statistical pooling for incidence estimates was 
      performed according to a random-effects model with generic inverse-variance 
      weighting, computing risk estimates with 95% confidence intervals (CIs), using 
      RevMan 5.3. RESULTS: A total of 14 reports comparing MitraClip with SMVR, 
      enrolling 3355 patients with severe MR, were included in this study. Mean age, 
      Logistic EuroSCORE, and incidence of diabetes mellitus (DM) were significantly 
      higher in the MitraClip group, except the rate of patients with New York Heart 
      Association (NYHA) class of >II and mean value of ejection fraction (EF). The 
      arithmetic mean of freedom from acute mobility was similar. The 2 groups had 
      equal all-cause mortality at 30 days, but different at 1 year (14% versus 9%) and 
      3 years in 7 studies (37% versus 25%). The freedom from recurrent MR >/=3+ was 88% 
      and 97.3% at 30 days, 76.0% and 90.0% at 1 year, and 79% and 95% at 3 years in 
      the MitraClip and surgical repair group, respectively. CONCLUSION: Although 
      MitraClip is safe and effective in selected high-risk patients, the surgery may 
      be the only gold standard for "gray" patients. Further studies are needed to 
      determine whether MitraClip should be recommended.
CI  - 2021 Forum Multimedia Publishing, LLC
FAU - Yuan, Haoyong
AU  - Yuan H
AD  - Department of Cardiovascular Surgery, the Second Xiangya Hospital, Central South 
      University, Changsha, Hunan, China.
AD  - Engineering Laboratory of Hunan Province for Cardiovascular Biomaterials, Hunan, 
      China. owenzswu@csu.edu.cn.
FAU - Wei, Tingting
AU  - Wei T
AD  - Department of Pediatrics, Hunan Provincial Maternal and Child Health Care 
      Hospital, Hunan, China.
FAU - Wu, Zhongshi
AU  - Wu Z
AD  - Department of Cardiovascular Surgery, the Second Xiangya Hospital, Central South 
      University, Changsha, Hunan, China.
AD  - Engineering Laboratory of Hunan Province for Cardiovascular Biomaterials, Hunan, 
      China. owenzswu@csu.edu.cn.
FAU - Lu, Ting
AU  - Lu T
AD  - Department of Cardiovascular Surgery, the Second Xiangya Hospital, Central South 
      University, Changsha, Hunan, China.
AD  - Engineering Laboratory of Hunan Province for Cardiovascular Biomaterials, Hunan, 
      China. owenzswu@csu.edu.cn.
FAU - Chen, Jinlan
AU  - Chen J
AD  - Department of Cardiovascular Surgery, the Second Xiangya Hospital, Central South 
      University, Changsha, Hunan, China.
FAU - Zeng, Yifan
AU  - Zeng Y
AD  - Department of Cardiovascular Surgery, the Second Xiangya Hospital, Central South 
      University, Changsha, Hunan, China.
FAU - Tan, Ling
AU  - Tan L
AD  - Department of Cardiovascular Surgery, the Second Xiangya Hospital, Central South 
      University, Changsha, Hunan, China.
AD  - Engineering Laboratory of Hunan Province for Cardiovascular Biomaterials, Hunan, 
      China. owenzswu@csu.edu.cn.
FAU - Huang, Can
AU  - Huang C
AD  - Department of Cardiovascular Surgery, the Second Xiangya Hospital, Central South 
      University, Changsha, Hunan, China.
AD  - Engineering Laboratory of Hunan Province for Cardiovascular Biomaterials, Hunan, 
      China. owenzswu@csu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20210215
PL  - United States
TA  - Heart Surg Forum
JT  - The heart surgery forum
JID - 100891112
SB  - IM
MH  - Cardiac Catheterization/*methods
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Humans
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/*surgery
EDAT- 2021/02/27 06:00
MHDA- 2021/07/21 06:00
CRDT- 2021/02/26 12:11
PHST- 2020/10/27 00:00 [received]
PHST- 2020/11/13 00:00 [accepted]
PHST- 2021/02/26 12:11 [entrez]
PHST- 2021/02/27 06:00 [pubmed]
PHST- 2021/07/21 06:00 [medline]
AID - 10.1532/hsf.3433 [doi]
PST - epublish
SO  - Heart Surg Forum. 2021 Feb 15;24(1):E108-E115. doi: 10.1532/hsf.3433.