Characteristics and outcomes of patients screened for transcatheter mitral valve implantation: 1-year results from the CHOICE-MI registry.

Ben Ali, Walid; Ludwig, Sebastian; Duncan, Alison; Weimann, Jessica; Nickenig, Georg; Tanaka, Tetsu; Coisne, Augustin; Vincentelli, Andre; Makkar, Raj; Webb, John G; Akodad, Mariama; Muller, David W M; Praz, Fabien; Wild, Mirjam G; Hausleiter, Jörg; Goel, Sachin S; von Ballmoos, Moritz Wyler; Denti, Paolo; Chehab, Omar; Redwood, Simon; Dahle, Gry; Baldus, Stephan; Adam, Matti; Ruge, Hendrik; Lange, Rüdiger; Kaneko, Tsuyoshi; Leroux, Lionel; Dumonteil, Nicolas; Tchetche, Didier; Treede, Hendrik; Flagiello, Michele; Obadia, Jean-Francois; Walther, Thomas; Taramasso, Maurizio; Søndergaard, Lars; Bleiziffer, Sabine; Rudolph, Tanja K; Fam, Neil; Kempfert, Joerg; Granada, Juan F; Tang, Gilbert H L; von Bardeleben, Ralph Stephan; Conradi, Lenard; Modine, Thomas     «

Ben Ali, Walid; Ludwig, Sebastian; Duncan, Alison; Weimann, Jessica; Nickenig, Georg; Tanaka, Tetsu; Coisne, Augustin; Vincentelli, Andre; Makkar, Raj; Webb, John G; Akodad, Mariama; Muller, David W M; Praz, Fabien; Wild, Mirjam G; Hausleiter, Jörg; Goel, Sachin S; von Ballmoos, Moritz Wyler; Denti, Paolo; Chehab, Omar; Redwood, Simon; Dahle, Gry; Baldus, Stephan; Adam, Matti; Ruge, Hendrik; Lange, Rüdiger; Kaneko, Tsuyoshi; Leroux, Lionel; Dumonteil, Nicolas; Tchetche, Didier; Treede, Hendrik;...     »

AIMS: Transcatheter mitral valve implantation (TMVI) represents a novel treatment option for patients with mitral regurgitation (MR) unsuitable for established therapies. The CHOICE-MI registry aimed to investigate outcomes of patients undergoing screening for TMVI. METHODS AND RESULTS: From May 2014 to March 2021, patients with MR considered suboptimal candidates for transcatheter edge-to-edge repair (TEER) and at high risk for mitral valve surgery underwent TMVI screening at 26 centres. Characteristics and outcomes were investigated for patients undergoing TMVI and for TMVI-ineligible patients referred to bailout-TEER, high-risk surgery or medical therapy (MT). The primary composite endpoint was all-cause mortality or heart failure hospitalization after 1 year. Among 746 patients included (78.5 years, interquartile range [IQR] 72.0-83.0, EuroSCORE II 4.7% [IQR 2.7-9.7]), 229 patients (30.7%) underwent TMVI with 10 different dedicated devices. At 1 year, residual MR ≤1+ was present in 95.2% and the primary endpoint occurred in 39.2% of patients treated with TMVI. In TMVI-ineligible patients (n = 517, 69.3%), rates of residual MR ≤1+ were 37.2%, 100.0% and 2.4% after bailout-TEER, high-risk surgery and MT, respectively. The primary endpoint at 1 year occurred in 28.8% of patients referred to bailout-TEER, in 42.9% of patients undergoing high-risk surgery and in 47.9% of patients remaining on MT. CONCLUSION: This registry included the largest number of patients treated with TMVI to date. TMVI with 10 dedicated devices resulted in predictable MR elimination and sustained functional improvement at 1 year. In TMVI-ineligible patients, bailout-TEER and high-risk surgery represented reasonable alternatives, while MT was associated with poor clinical and functional outcomes.      «

AIMS: Transcatheter mitral valve implantation (TMVI) represents a novel treatment option for patients with mitral regurgitation (MR) unsuitable for established therapies. The CHOICE-MI registry aimed to investigate outcomes of patients undergoing screening for TMVI. METHODS AND RESULTS: From May 2014 to March 2021, patients with MR considered suboptimal candidates for transcatheter edge-to-edge repair (TEER) and at high risk for mitral valve surgery underwent TMVI screening at 26 centres. Charac...     »