Study Suggests Most Mitral Regurgitation Patients Treated With TEER Will Require Mitral Replacement Surgery if Treatment Fails

Newswise — Boston, MA (April 28, 2021) – A new study, presented today at the AATS 101^st Annual Meeting, and simultaneously published in the Journal of the American College of Cardiology, finds that patients suffering from severe mitral regurgitation should be carefully screened and counselled before undergoing transcatheter edge-to-edge mitral repair (TEER). Data showed that up to 95 percent of patients who needed surgery after failed TEER could not have their valves repaired, and needed mitral valve replacement to resolve the issue.  The findings highlight the need to select patients carefully for TEER.

As a less invasive approach, TEER is an attractive alternative treatment to mitral valve surgery, particularly in older patients. However, TEER is not currently recommended for younger patients who benefit more from a surgical repair long-term. This caution is supported by this study of 463 patients which provides the first national data on surgical outcomes when TEER fails. The surgical repair rate after failed TEER was only 4.8 percent overall, and 6.8 percent in degenerative disease.

“The fact that TEER takes surgical repair off the table as an option for patients makes it essential that we have a very clear understanding of which patients will benefit. This finding has important implications for treatment choice in lower-risk patients with degenerative disease.” said Dr. Joanna Chikwe, chair of the Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai and the Irina and George Schaeffer Distinguished Chair in Cardiac Surgery in honor of Alfredo Trento, MD.  “These findings should inform patient consent for TEER, design of clinical trials, and clinical performance measures.”

Results of additional industry studies and an NIH-funded trial comparing TEER to mitral surgery should be published within the next two years and may result in updated guidelines on the use of TEER to treat degenerative mitral regurgitation. 

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Notes for Editors:

“Operative outcomes of mitral surgery for failed transcatheter edge-to-edge repair (TEER) in the United States.” Joanna Chikwe, Patrick O'Gara, Stephen Fremes, Thoralf Sundt, Robert Habib, Georgina Rowe, George Gill, James Gammie, Mario Gaudino, Vinay Badhwar, Michael Acker, Marc Gillinov, Andrew B Goldstone, Thomas Schwann, Annetine Gelijns, Natalia N Egorova, Alfredo Trento, Michael Mack, David H Adams. Cedars-Sinai, Beverly Hills, CA; Brigham and Women’s Hospital, Boston, MA; Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada; Massachusetts General Hospital, Boston, MA; The Society of Thoracic Surgeons Research Center, Chicago, IL; University of Maryland, Baltimore, MD; Weill Cornell, New York, NY; West Virginia University, Morgantown, WV; University of Pennsylvania, Philadelphia, PA; Cleveland Clinic, Cleveland, OH; Baystate Health, Springfield, MA; Icahn School of Medicine at Mount Sinai, New York, NY; Baylor Health Care System, Plano, TX

Presented by Joanna Chikwe, MD on May 1, 2021 at the AATS 101st Annual Meeting.

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The American Association for Thoracic Surgery (AATS) is an international organization that encourages, promotes, and stimulates the scientific investigation of cardiothoracic surgery. Founded in 1917 by a respected group of the earliest pioneers in the field, its original mission was to “foster the evolution of an interest in surgery of the Thorax.” Today, the AATS is the premiere association for cardiothoracic surgeons in the world and works to continually enhance the ability of cardiothoracic surgeons to provide the highest quality of patient care. Its more than 1,500 members have a proven record of distinction within the specialty and have made significant contributions to the care and treatment of cardiothoracic disease. Visit www.aats.org to learn more.