Authors:	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. Wyler von Ballmoos, Moritz 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, TMichele 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. Bardeleben, Ralph Stephan von Conradi, Lenard Modine, Thomas
Contributor:	CHOICE-MI Investigators
Title:	Characteristics and outcomes of patients screened for transcatheter mitral valve implantation : 1-year results from the CHOICE-MI registry
Online publication date:	19-Jan-2023
Year of first publication:	2022
Language:	english
Abstract:	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.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-8601
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY-NC-ND
Information on rights of use:	https://creativecommons.org/licenses/by-nc-nd/4.0/
Journal:	European journal of heart failure 24 5
Pages or article number:	887 898
Publisher:	Wiley
Publisher place:	Oxford u.a
Issue date:	2022
ISSN:	1879-0844
Publisher DOI:	10.1002/ejhf.2492
Appears in collections:	DFG-491381577-H