Real-world outcomes of TMVR-eligible and TMVR-ineligible patients

Aims: Over the past decade, transcatheter valve replacement has emerged as a therapy for selected patients with valvular heart. Clinical experience with transcatheter mitral valve replacement (TMVR) has been limited to date and provides little insight into its potential as a viable therapy for MR. The present study aims to analyze the current longest follow-up real-life outcomes of TMVR procedures with a specific focus on the patient population left untreated due to the unfeasibility of the procedure. Results: Out of 3400 patients referred for mitral pathology, 88 were screened for TMVR procedure, being unfeasible for surgical and TEER procedure (Transcatheter Edge-to-Edge Repair). 37 pts (45%) were screened positive and treated with TMVR; 30 (81%) with Tendyne system (Abbott) and 7 (19%) with Tiara. For cardiac death, in TMVR the survival was 97.2%, 90.7%, and 90.7% at 1, 2, and 4 years, respectively. Concerning MT, instead, it was 86.4%, 77%, and 42% at 1, 2, and 4 years, respectively. A difference is seen between the two groups, P-value 0.024. Conclusion: TMVR is a valid option in selected patients and give valid longer follow-up results. The TMVR-ineligible patients showed a progressive detrimental worse survival across the follow-up.