Pilot European Sentinel Registry Supports Transcatheter Mitral Valve Repair

August 27, 2014—Georg Nickenig, MD, et al published in-hospital results and 1-year follow-up of 628 patients with mitral regurgitation (MR) undergoing transcatheter mitral valve repair (TMVR) in the 2011–2012 Pilot European Sentinel Registry in the Journal of the American College of Cardiology (2014;64:875–884). 

The aim of this multinational registry is to present a real-world overview of TMVR use in Europe. TMVR has gained widespread acceptance in Europe, but data on immediate success, safety, and long-term echocardiographic follow-up in real-world patients are still limited, noted the investigators in the background to the study.

The investigators concluded that this independent, contemporary registry shows that TMVR is associated with high immediate success, low complication rates, and sustained 1-year reduction of the severity of MR and improvement of clinical symptoms.

As summarized in the Journal of the American College of Cardiology, the Transcatheter Valve Treatment Sentinel Pilot Registry is a prospective, independent, consecutive collection of individual patient data that enrolled 628 patients (mean age, 74.2 ± 9.7 years; 63.1% men) who underwent TMVR between January 2011 and December 2012 at 25 centers in eight European countries. The prevalent pathogenesis was functional MR (n = 452 [72%]). The majority of patients (85.5%) were highly symptomatic (New York Heart Association functional class III or higher), with a high logistic EuroSCORE (20.4% ± 16.7%). 

The investigators reported that acute procedural success was high (95.4%) in patients with functional and degenerative MR (P = .662). One clip was implanted in 61.4% of patients. In-hospital mortality was low (2.9%), without significant differences between groups. 

The estimated 1-year mortality was 15.3%, which was similar for functional and degenerative MR. The estimated 1-year rate of rehospitalization due to heart failure was 22.8% and was significantly higher in the functional MR group (25.8% vs 12%; P [log-rank] = .009). Paired echocardiographic data from the 1-year follow-up, which was available for 368 consecutive patients in 15 centers, showed a persistent reduction in the degree of MR at 1 year (6% of patients with severe MR), advised the registry investigators in the Journal of the American College of Cardiology.