Outcomes of mitral valve transcatheter edge to edge repair in patients with coronary chronic total occlusion.

Introduction: It remains unknown whether the concomitant coronary chronic total occlusion (CTO) would affect the outcomes of the Mitral valve Trans-catheter Edge to edge-to-edge repair (M-TEER) procedure.

Methodology: Study population was extracted from the Nationwide Inpatient Sample Data using the International Classification of Diseases and clinical modifications/procedure coding system codes for M-TEER and CTO. Primary outcomes were in-hospital all-cause mortality and net cardiac periprocedural complications. Propensity matching was used to extract a matched control (M-TEER-CTO and M-TEER-No CTO).

Results: A total of 48,835 cases of M-TEER were identified in the United States between January 2016 and December 2020, of whom 700 patients (1.5%) had the diagnosis of coronary total occlusion (CTO). The mean age of M-TEER patients was not significantly different between the two groups (76 vs. 75 years, p = 0.11); however, the CTO cohort had a higher percentage of males (66.72% vs. 53.41%, p = 0.002). M-TEER-CTO had higher odds of net all cardiac periprocedural complications (aOR 1.83,95% CI (1.17-2.84), p = 0.007) compared to the no-CTO group, however, there was no difference in in-hospital mortality (aOR 1.54, 95%CI (0.52-4.56), p = 0.43).

Conclusions: Patients undergoing M-TEER with CTO had a higher incidence of net all cardiac periprocedural complications but similar mortality compared to those with no CTO.