Efficacy and Safety of Transcatheter Mitral Valve Edge-to-Edge Repair with a MitraClip Device in Real-World Canadian Practice
Bibliographic record
Abstract
BACKGROUND Mitral transcatheter edge-to-edge repair (M-TEER) is a treatment option for patients with symptomatic mitral regurgitation (MR). The real-world experience with M-TEER in Canada has not been previously reported. METHODS We conducted an observational study of 1,191 patients from 11 Canadian centers undergoing M-TEER with MitraClip. M-TEER databases from each center were centrally collected and merged into a single Canada-wide database. The primary outcome was MR severity before M-TEER versus up to 1-year after M-TEER. Secondary outcomes included hospitalizations for heart failure (HHF) and NYHA functional class. RESULTS MR etiology was degenerative in 41% and functional in 59%. The mean age was 76 years and 36% were women. The proportion with MR ≥ 3+ was 97.3% before versus 11.0% up to 1-year after M-TEER (absolute risk difference [ARD] 86.4%, P<0.001). HHF occurred in 50.7% before versus 10.3% up to 1-year after M-TEER (ARD 40.4%, P<0.001), with similar benefit in patients with functional (ARD 44.8%, 95% CI 39.5-50.1) and degenerative (ARD 34.8%, 95% CI 29.0-40.6) MR. NYHA class III-IV HF was present in 82.8% before versus 16.6% up to 1-year after M-TEER (ARD 66.2%, P<0.001). Single-leaflet detachment (1.0%) MV surgery (2.2%) were infrequent. Mortality was 1.3% in-hospital and 12.7% at 1-year. CONCLUSION In this first national registry of M-TEER in Canada, M-TEER resulted in a sustained reduction in MR and was associated with reduced heart failure hospitalizations and improvement in NYHA functional class, with a high degree of safety. This benefit was consistent in patients with functional and degenerative MR.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".