Why Did COAPT Win While MITRA-FR Failed? Defining the Appropriate Patient Population for MitraClip.

Publication Title

Interv Cardiol

Authors

Kimberly Atianzar, Swedish Heart and Vascular Institute Seattle, WA, US.
Ming Zhang, Swedish Medical Center, Seattle, WashingtonFollow
Zachary Newhart, Swedish Heart and Vascular Institute Seattle, WA, US.Follow
Sameer Gafoor, Swedish Heart and Vascular, Seattle, WA, USA.Follow

Document Type

Article

Publication Date

2-1-2019

Keywords

COAPT; MITRA-FR; Mitral regurgitation; congestive heart failure; effective orifice area; functional mitral regurgitation; heart failure; optimal medical therapy; secondary mitral regurgitation

Abstract

In 2018, the world of functional mitral regurgitation changed with the presentation of two trials - Multicentre Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation (MITRA-FR) and Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT). The trials, which seemed to point in two different directions, raised significant questions for the field. This article looks at the differences in effective regurgitant area, guideline-directed medical therapy, patient selection, technical clues and other reasons why the trials had similar aims but very different findings.

Area of Special Interest

Cardiovascular (Heart)

Specialty/Research Institute

Cardiology