Mitral valve clip for treatment of mitral regurgitation: an evidence-based analysis

Ansari MT, Ahmadzai N, Coyle K, Coyle D, Moher D
Record ID 32015000777
English
Authors' recommendations: Chronic mitral regurgitation is a long-standing abnormal leakage of blood back into 1 of the heart chambers as the heart attempts to pump blood to the rest of the body. It occurs because the mitral valve is either anatomically distorted or functionally abnormal. Severe chronic mitral regurgitation is debilitating and requires corrective cardiac surgery. But many of the 500,000 patients in North America who have chronic mitral regurgitation are elderly and for various reasons are at prohibitive risk for surgery. For such patients, an approach has been proposed that involves a catheter puncturing the skin of the groin and travelling all the way to the affected valve to deploy a device that clips and repairs the valve leaflets (a mitral valve clip). This investigation sought to compare the effectiveness and cost-effectiveness of mitral valve clips with current standards of care in patients at high or prohibitive risk for surgery. To address this uncertainty, we searched, critically appraised, and collated existing research evidence. We found sparse, very-low-quality evidence related to mitral valve clips. Most of the evidence was in populations not particularly at high risk for surgery. Important limitations in the design, conduct, and size of the studies precluded definitive conclusions about the relative effectiveness, harms, and cost-effectiveness of mitral valve clips when compared with conservative management in patients at prohibitive risk for surgery. No meaningful conclusions can be drawn about the comparative effectiveness, harms, and cost-effectiveness of mitral valve clips in the population with chronic mitral regurgitation who are at prohibitive risk for surgery.
Details
Project Status: Completed
Year Published: 2015
URL for published report: http://www.hqontario.ca/Portals/0/Documents/eds/ohtas/eba-mitral-valve-clip-1505-en.pdf
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Heart Valve Prosthesis
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Heart Valve Prosthesis Implantation
  • Minimally Invasive Surgical Procedures
  • Cardiac Catheterization
Contact
Organisation Name: Health Quality Ontario
Contact Address: Evidence Development and Standards, Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario Canada M5S 1N5
Contact Name: EDSinfo@hqontario.ca
Contact Email: OH-HQO_hta-reg@ontariohealth.ca
Copyright: Health Quality Ontario (HQO)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.