COAPT Trial of Transcatheter Mitral Valve Repair in Patients with Heart Failure

COAPT Trial of Transcatheter Mitral Valve Repair in Patients with Heart Failure Patients with heart failure and left ventricular dilatation may have secondary or functional mitral regurgitation. This is due to alteration of the left ventricular geometry producing changes in the functioning of papillary muscles and chordae tendineae and poor coaptation of the mitral leaflets. Secondary mitral regurgitation causes volume overloading of the left ventricle and is associated with reduced survival, increased hospitalization rates and decreased quality of life [1, 2]. Secondary mitral regurgitation can be reduced by guideline directed medical therapy and cardiac resynchronization therapy. This will also provide symptomatic relief and improve left ventricular function. EVEREST II trial comparing percutaneous mitral valve repair and surgery for mitral regurgitation had concluded that percutaneous repair was less effective at reducing mitral regurgitation than conventional surgery. But percutaneous repair was associated with superior safety and similar improvements in clinical outcome. An exploratory subgroup analysis of EVEREST II trial showed that surgery was not superior to percutaneous treatment in functional mitral regurgitation [3]. This observation was the reason for initiating the COAPT Trial of Transcatheter Mitral Valve Repair in Patients with Heart Failure [4]. COAPT trial was conducted at 78 sites across United States and Canada and enrolled patients with heart failure havi...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Structural Heart Disease Interventions Source Type: blogs