Outcomes of COMBO therapy for severe mitral regurgitation compared with transcatheter edge-to-edge repair

• Published in: Frontiers in cardiovascular medicine 2024-02, Vol.11, p.1223588-1223588
• Main Authors: Yokoyama, Hiroaki, Ruf, Tobias Friedrich, Gößler, Theresa Ann Maria, Geyer, Martin, Zirbs, Julia, Schwidtal, Ben Luca, Münzel, Thomas, von Bardeleben, Ralph Stephan
• Format: Article
• Language: English
• Subjects: Cardiovascular Medicine; COMBO therapy; M-TEER; mitral regurgitation; mitral transcatheter edge-to-edge therapy; transcatheter mitral valve repair (TMVr)
• ISSN: 2297-055X; 2297-055X
• DOI: 10.3389/fcvm.2024.1223588

There are different types of transcatheter mitral valve repair (TMVr) currently in clinical use, including leaflet approximation, annular cinching, and restoration of the chordal apparatus of the mitral valve (MV). While the concomitant combination (COMBO) therapy of mitral transcatheter edge-to-edge repair (M-TEER) with another TMVr concept has been proven feasible, potentially offering patient-tailored treatment for severe mitral regurgitation (MR), a comparison with M-TEER alone has not been made. To evaluate the procedural and clinical outcome of COMBO therapies compared with M-TEER alone. We included consecutive patients undergoing COMBO and M-TEER between March 2015 and April 2018 at our Heart Valve Center, while excluding patients presenting a case of redo or with previous MV surgery. Procedural outcomes and all-cause mortality were compared between COMBO therapy vs. M-TEER alone. A total of 357 patients (mean age 78.9 ± 7.0 years, 53.2% male, M-TEER  = 322, COMBO  = 35; COMBO: MitraClip and the Carillon mitral contour system  = 26, MitraClip and Cardioband  = 5, and MitraClip and NeoChord  = 4) were analyzed. Patients with COMBO therapy had larger left chamber sizes, a lower left ventricular systolic ejection fraction (LVEF; COMBO: 37.4 ± 13.8%, M-TEER: 47.9 ± 14.3%,