MitraClip: How Do We Reconcile the Inconsistent Findings of MITRA-FR and COAPT?

Rina Mauricio, Dharam J. Kumbhani

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Secondary mitral regurgitation (MR) is a common valvular disorder in patients with left ventricular (LV) dysfunction and is associated with worse morbidity and mortality. New data on percutaneous mitral valve (MV) repair suggest that targeting the valve itself may improve outcomes. Our objective is to review two recent trials (MITRA-FR and COAPT) with regard to percutaneous MV repair. We will dive into their methodology and results and propose potential explanations for their divergent outcomes. Recent Findings: MITRA-FR and COAPT studied the MitraClip plus guideline-directed medical therapy (GDMT) versus GDMT alone in patients with secondary MR. COAPT found an overwhelming benefit in reduction in HF hospitalization and mortality whereas MITRA-FR found no difference between treatment groups. Patient selection, differences in procedural outcomes, and smaller LV dimensions may explain these diametrically opposed results. Summary: Secondary MR is a common valvular disorder with complex pathophysiology. There are certain patients who will not benefit from percutaneous MV repair. The results of MITRA-FR and COAPT suggest that percutaneous MV repair may benefit carefully selected individuals with secondary MR on maximum tolerated doses of GDMT.

Original languageEnglish (US)
Article number150
JournalCurrent Cardiology Reports
Volume21
Issue number12
DOIs
StatePublished - Dec 1 2019

Keywords

  • COAPT
  • MITRA-FR
  • Mitral regurgitation
  • Transcatheter repair

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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