Overview
Acute mitral regurgitation (MR) can result from chordal rupture, leading to significant hemodynamic compromise. Transcatheter edge-to-edge repair (TEER) is a minimally invasive option for patients with prohibitive surgical risks 1.Diagnosis
Diagnosis is typically made via echocardiography, which can identify the severity of MR and the underlying cause, such as chordal rupture.Management
Transcatheter edge-to-edge repair (TEER) is an option for patients with prohibitive surgical risks 1.
Devices for TEER include the MitraClip and the PASCAL system 1.
Technical success rates for TEER are high, with MR ≤2 at 30-day follow-up reported in approximately 89-90% of patients 1.
Outcomes, including all-cause mortality, major bleeding, and reintervention rates, are comparable between the MitraClip and PASCAL devices 1.
Device success was more frequent with the PASCAL device, though not statistically significant in one meta-analysis 1.Key Recommendations
Transcatheter edge-to-edge repair (TEER) is a feasible treatment option for mitral regurgitation in patients with prohibitive surgical risks 1. (Evidence: Moderate)
Both the MitraClip and PASCAL devices demonstrate comparable safety and effectiveness for TEER, with similar rates of technical success and MR reduction at 30 days 1. (Evidence: Moderate)
The choice between MitraClip and PASCAL devices should be guided by specific factors, though these are not detailed in the provided abstract 1. (Evidence: Expert opinion)References
1 Alqeeq BF, Al-Tawil M, Hamam M, Aboabdo M, Elrayes MI, Leick J et al.. Transcatheter edge-to-edge repair in mitral regurgitation: A comparison of device systems and recommendations for tailored device selection. A systematic review and meta-analysis. Progress in cardiovascular diseases 2023. link