Outcomes of Mitral Valve Transcatheter Edge-To-Edge Repair In Patients With Chronic Kidney Disease: A Systematic Review And Meta-Analysis

Ashraf Ahmed; Fabricio Webber; Rasha Kaddoura; Mohamed Badheeb; Erica Marnet; Sandeep Nayak; Md Mashiul; Didien Meyahnwi; Abhinav Aggarwal; Gilead Lancaster

doi:10.36923/jhvd.v29i1.214

Open Access Article

Ashraf Ahmed⁽¹⁾ , Fabricio Webber⁽²⁾ , Rasha Kaddoura⁽³⁾ , Mohamed Badheeb⁽⁴⁾ , Erica Marnet⁽⁵⁾ , Sandeep Nayak⁽⁶⁾ , Md Mashiul⁽⁷⁾ , Didien Meyahnwi⁽⁸⁾ , Abhinav Aggarwal⁽⁹⁾ , Gilead Lancaster⁽¹⁰⁾

(1) Internal Medicine Department, Yale New Haven Health, Bridgeport Hospital, CT, USA,

(2) Department of Cardiovascular Diseases, University of Miami, FL, USA,

(3) Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar,

(4) Internal Medicine Department, Bridgeport Hospital, Yale New Haven Health, CT, USA,

(5) Internal Medicine Department, Bridgeport Hospital, Yale New Haven Health, CT, USA,

(6) Internal Medicine Department, Bridgeport Hospital, Yale New Haven Health, CT, USA,

(7) Internal Medicine Department, Bridgeport Hospital, Yale New Haven Health, CT, USA,

(8) Internal Medicine Department, Bridgeport Hospital, Yale New Haven Health, CT, USA,

(9) Internal Medicine Department, Bridgeport Hospital, Yale New Haven Health, CT, USA,

(10) Department of Cardiovascular Diseases, Bridgeport Hospital, Yale New Haven Health, CT, USA

https://doi.org/10.36923/jhvd.v29i1.214

Issue
Vol. 29 No. 1 (2024)

Submitted
July 14, 2024

Published
October 13, 2024

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Abstract

Background: Transcatheter edge-to-edge repair of the mitral valve (M-TEER) improves outcomes in patients with chronic severe symptomatic mitral valve regurgitation who are at high risk for surgical mitral valve repair or replacement. This systematic review and meta-analysis aimed to describe the outcomes of M-TEER in patients with moderate-to-severe (stage III; Group 1) chronic kidney diseases (CKD) and end-stage kidney disease (stages IV-V; Group 2) in comparison with those with normal kidney function or mild CKD (stages I-II; Group 3). Methods: A systematic literature search of PubMed, Scopus, and Embase was conducted from inception to December 10th, 2023. The odds ratio (OR) with a 95% confidence interval (CI) was pooled using the random-effects model. Results: We screened 6,090 articles of which 40 citations were reviewed in full texts. Eight cohort observational studies met the eligibility criteria. Group 1 versus Group 3: short-term and long-term mortality were significantly higher in Group 1 [(OR 1.73, CI: 1.30-2.29) and (OR 1.78, CI: 1.38-2.29), respectively]. The shock was significantly higher (OR 1.95, CI: 1.45-2.63), and vascular complications were significantly lower (OR 0.51, CI: 0.26-0.99) in Group 1. The incidence of stroke, cardiac tamponade, or conversion to open surgery did not differ between groups [OR 0.87, CI: 0.34-2.23), (OR 1.52, CI: 0.62-2.75), or (OR 0.53, 95% CI: 0.12-2.24), respectively]. Group 2 versus Group 3: long-term mortality was significantly higher in Group 2 (OR 3.56, CI: 2.53-5.02) without a difference in short-term mortality (OR 4.92, CI: 0.91-26.72) or conversion to open surgery (OR 0.92, CI: 0.45-1.91) between groups. Conclusion: In patients who are undergoing M-TEER, impaired kidney function may be associated with increased odds of mortality in comparison with absence or mild kidney impairment.

Keywords:

Symptomatic mitral valve, Transcatheter, Edge-To-Edge Repair, Chronic Kidney Disease, Systematic Review, Outcomes of M-TEER

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Authors

Ashraf Ahmed

Internal Medicine Department, Yale New Haven Health, Bridgeport Hospital, CT, USA

https://orcid.org/0000-0002-1029-2559

ashrafo2017@hotmail.com (Primary Contact)

Fabricio Webber

Department of Cardiovascular Diseases, University of Miami, FL, USA

https://orcid.org/0000-0001-6755-1067

Rasha Kaddoura

Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar

https://orcid.org/0000-0003-2613-9759

Mohamed Badheeb