Current status of transcatheter mitral valve therapy in Europe: Results from an EAPCI survey (Part II)

Aims: The European Association of Percutaneous Coronary Interventions (EAPCI) assessed the current status of transcatheter valve therapy in Europe through a web-based survey. Our aim here was to report the results of that survey regarding trends in percutaneous mitral valve repair (PMVR) therapy. Methods and results: Among 301 European centres participating in the overall EAPCI survey, 246 (81.7%) responded to the PMVR section questions. A total of 176 (71.5%) have been undertaking a PMVR programme. Among responding centres (n=129), 58.1%, 15.5% and 26.4% performed ≤10, >10-40 and >40 PMVR procedures, respectively, in 2014. The majority of centres performing >40 PMVR procedures in 2014 were in Germany (82.4%). MitraClip was the most commonly performed technique (used in 91.8% of centres) followed by the valve-in-ring or valve-in-valve for failed surgical prostheses using transcatheter aortic valve devices (41.5%). Of those centres not performing PMVR (n=70), 41.4% were not considering initiating a programme, mostly for economic reasons (69.0%), or because of limited data available (20.7%) or no interest (10.3%). Conclusions: The second part of this EAPCI survey documents the limited PMVR penetration in Europe, despite an increasing interest. Possible reasons for this include economic, regulatory and logistic issues, challenging techniques, along with a lack of compelling studies and clear indications.