TRANSCATHETER MITRAL VALVE REPAIR IN A SURGICAL UNIT: UPDATED RESULTS

Background and Aim: Transcatheter edge-to-edge repair (TEER) has been introduced as a valuable tool for the treatment of high-risk patients affected by mitral valve regurgitation. We present the results of a dedicated surgical team. Methods: From November 2020 to August 2024, Fifty-four patients (median age 81 y.o, range 39-90, 55% male, 1 urgent procedure) with severe mitral valve regurgitation underwent TEER. A dedicated structural valve team has been established. All cases have been approved by the local weekly heart team according risk profile or specific contra-indication to conventional surgery. Data were collected prospectively. Results: Twenty-two patients (40%) were affected by functional MR of whom two cases were performed as bridge to heart transplantation. In the remaining cases, P2 prolapse was present in (50%) patients, leaflet retraction and commissural disease in 10%. Procedural success (MR<2) was achieved in 92% of cases. In the elective cases, 30-day survival was 98%. Kaplan Meier Freedom from cardiac death was 85±5% and 77±3% at 12 and 24 months. Freedom from MR recurrence (>2+) at 12 months was 90±3%%. At mean follow up of 11±2 months, functional status significantly improved (NYHA class 3±0.8 vs 1.25±0.25). Conclusions: Surgeon’s headed transcatheter mitral valve repair program is a feasible concept that can should expanded in dedicated centers. TEER is a safe and reproducible procedure that represents a useful tool in armamentarium of the contemporary cardiac surgeon. Late results have to be balanced with the preoperative patient’s characteristics