Managing Mitral Regurgitation in Heart Failure —Perspectives After COAPT

AbstractPurpose of reviewFunctional mitral regurgitation (MR) in setting of cardiomyopathy causes significant morbidity and worsened survival. Surgical therapies have failed to demonstrate significant overall benefit for functional MR. More recently, major trials utilizing transcatheter therapies for functional MR have been completed and offer new avenues for intervention. This review evaluates and compares 2 major recent trials designed to test the benefit of edge-to-edge repair using the MitraClip system for severe functional MR.Recent findingsThe Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) and Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation (MITRA-FR) trials were simultaneous trials evaluating the treatment of effect of MitraClip in the setting of severe functional mitral regurgitation. Results of the trials were quite different with COAPT demonstrating substantial clinical benefit including significantly improved survival compared with MITRA-FR in which no clinical benefit was derived.SummaryKey differences in the patient population between the COAPT and MITRA-FR trials help to explain the contrasting results between the 2 trials designed to test the same hypothesis. Patients in COAPT had higher severity of MR with less dilated ventricles compared with MITRA-FR. These results will help shape patient selection for who will ...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research