Journal of Interventional Cardiology

Research Article

Transcatheter Mitral Valve Replacement in High-Surgical Risk Patients: A Single-Center Experience and Outcome

Table 1

Baseline demographic, clinical, and echocardiographic characteristics of the studied patients.


Preprocedural characteristics	TMVR total N: 64	Groups			value
Preprocedural characteristics	TMVR total N: 64	TMViV N: 35 (55%)	TMViR N: 16 (25%)	TMViMAC N: 13 (20%)	value

Demographic characteristics
Age (years)	62.7 ± 16.1	58.0 ± 19.5	66.2 ± 7.7	71.1 ± 7.7	0.024
Female gender	35 (54.7%)	22 (62.9%)	8 (50.0%)	5 (38.5%)	0.291
Weight (kg)	61.7 ± 10.5	61.6 ± 11.0	64.3 ± 11.2	59.0 ± 8.0	0.404
Height (m)	1.6 ± 0.15	1.6 ± 0.2	1.6 ± 0.1	1.6 ± 0.1	0.316
BSA (m²)	3.9 ± 18.5	1.6 ± 0.2	1.6 ± 0.1	1.5 ± 0.1	0.087
Risk factors (high risk)
Diabetes mellitus	41 (64.1%)	17 (48.6%)	14 (87.5%)	10 (76.9%)	0.055
Hypertension	30 (46.9%)	13 (37.1%)	8 (50.0%)	9 (69.2%)	0.135
COPD/home oxygen	13 (20.3%)	4 (11.4%)	7 (43.8%)	2 (15.4%)	0.026
CKD/renal transplant	20 (31.3%)	3 (8.6%)	7 (43.8%)	10 (76.9%)	<0.001
Decompensating liver	4 (6.3%)	1 (2.9%)	2 (12.5%)	1 (7.7%)	0.406
Stroke	25 (39.1%)	8 (22.9%)	9 (56.3%)	8 (61.5%)	0.014
Peripheral vascular disease	7 (10.9%)	2 (5.7%)	3 (18.8%)	2 (15.4%)	0.325
Chronic anemia	9 (14.1%)	2 (5.7%)	1 (6.3%)	6 (46.2%)	<0.001
Previous cardiac history
Arrythmias (SVT, AF, VT, CHB)	35 (54.7%)	19 (54.3%)	7 (43.8%)	9 (69.2%)	0.070
Prior myocardial infarction	19 (29.7%)	0 (0.0%)	12 (75.0%)	7 (53.9%)	<0.001
Prior PCI	9 (14.1%)	1 (2.9%)	3 (18.8%)	5 (38.5%)	0.006
Prior CABG	18 (28.1%)	1 (2.9%)	12 (75.0%)	5 (38.5%)	<0.001
Prior AV replacement	9 (14.1%)	6 (17.1%)	0 (0.0%)	3 (23.1%)	0.047
Prior congenital surgery	1 (1.6%)	1 (2.9%)	0 (0.0%)	0 (0.0%)	0.656
Prior PPM/ICD	10 (15.6%)	7 (20.0%)	0 (0.0%)	3 (23.1%)	0.134
Previous anticoagulation	23 (35.9%)	8 (22.9%)	8 (50.0%)	7 (53.9%)	0.055
Prior HF hospitalization in last 12 months	42 (65.6%)	23 (65.7%)	13 (81.3%)	6 (46.2%)	0.141
Porcelain aorta	3 (4.7%)	0 (0.0%)	0 (0.0%)	3 (23.1%)	0.002
Timing of last MV surgery (Ys)	7.6 ± 5.5	9.9 ± 4.6	8.6 ± 4.0	0.0 ± 0.0
STS score (%)	9.2 ± 3.7	8.6 ± 4.1	9.6 ± 3.3	10.8 ± 5.6	0.442

Clinical presentations
Presentation
Palpitation	12 (18.8%)	5 (14.3%)	3 (18.8%)	4 (30.8%)	0.429
Dyspnea	64 (100.0%)	35 (100.0%)	16 (100.0%)	13 (100.0%)	0.656
Chest pain	2 (3.1%)	2 (5.7%)	0 (0.0%)	0 (0.0%)	0.425
Stroke	1 (1.6%)	1 (2.9%)	0 (0.0%)	0 (0.0%)	0.656
NYHA-FC
III	17 (26.6%)	9 (25.7%)	4 (25.0%)	4 (30.8%)	0.939
IV	47 (73.4%)	25 (71.4%)	13 (81.3%)	9 (69.2%)	0.939

Echocardiography data
Pathology of MV lesions
Degeneration	51 (79.7%)	35 (100.0%)	16 (100.0%)	0 (0.0%)	<0.001
Calcification	13 (20.3%)	0 (0.0%)	0 (0.0%)	13 (100.0%)	<0.001
Previous infective endocarditis	7 (10.9%)	5 (14.3%)	2 (12.5%)	0 (0.0%)	0.361
MV lesion
MS	20 (31.3%)	14 (40.0%)	4 (25.0%)	2 (15.4%)	0.043
MR	6 (9.4%)	1 (2.9%)	5 (31.3%)	0 (0.0%)	<0.001
Both	38 (59.4%)	20 (57.1%)	7 (43.8%)	11 (84.6%)	0.003
Severity of MS
Mild	2 (3.1%)	0 (0.0%)	2 (12.5%)	0 (0.0%)	<0.001
Moderate	6 (9.4%)	0 (0.0%)	3 (18.8%)	3 (23.1%)
Severe	50 (78.1%)	34 (97.1%)	6 (37.5%)	10 (76.9%)
MV area (cm²)	1.5 ± 0.6	1.1 ± 0.3	2.1 ± 0.8	1.6 ± 0.5	<0.001
Mean MV-Pg (mmHg)	14.3 ± 5.3	14.8 ± 5.1	12.1 ± 4.6	15.5 ± 6.4	0.162
Severity of MR
Trivial/Mild	3 (4.7%)	3 (8.6%)	0 (0.0%)	0 (0.0%)	0.319
Moderate	15 (23.4%)	8 (22.9%)	5 (31.3%)	2 (15.4%)
Severe	26 (40.6%)	10 (28.6%)	7 (43.8%)	9 (69.2%)
Type of MR
Paravalvular	3 (4.7%)	0 (0.0%)	3 (18.8%)	0 (0.0%)	0.022
Valvular	41 (64.1%)	21 (60.0%)	9 (56.3%)	11 (84.6%)	0.022

AF: atrial fibrillation, AV: aortic valve, BSA: body surface area, CABG: coronary artery bypass graft, CHB: complete heart block, CKD: chronic kidney disease, COPD: chronic obstructive pulmonary disease, HF: heart failure, MR: mitral regurgitation, MS: mitral stenosis, MV: mitral valve, NYHA-FC: New York heart association functional class, PCI: percutaneous coronary intervention, Pg: pressure gradient, PPM/ICD: permanent pacemaker/implantable cardioverter-defibrillator, STS: Society of Thoracic Surgeons, SVT: supraventricular tachycardia, TMVR: transcatheter mitral valve replacement, TMViV: transcatheter mitral valve-in-valve, TMViR: transcatheter mitral valve-in-ring, TMViMAC: transcatheter mitral valve-in-mitral annular calcification, VT: ventricular tachycardia.