Computed tomography-based assessment of left ventricular reverse remodeling and outcome after transcatheter mitral valve implantation with left ventricular apical anchoring (TENDYNE) compared to other

Abstract Background Transcatheter mitral valve implantation (TMVI) using an anchoring system at the left ventricular (LV) apex has developed as treatment option for high-surgical risk patients with severe mitral regurgitation (MR). Purposes The aim of this study was to compare TMVI with LV apical anchoring to traditional approaches, focusing on their impact on reverse remodeling and outcomes. Methods Data of consecutive patents who underwent TMVI with TENDYNE prosthesis and TMVI as valve-in-valve and valve-in-ring procedures between 2015 and 2024 were compared regarding post-procedural changes in LV end-diastolic volume index (LVEDVI), left atrial volume index (LAVI), LV ejection fraction (LVEF), LV sphericity index (LVSI) and LVOT-obstruction based on cardiac computed tomography (CCT). Changes in mitral valve pressure gradient (MV MPG) and presence of paravalvular leakage (PVL) were assessed echocardiography. Results We analyzed data of patients who underwent TMVI with TENDYNE prosthesis (Group 1, n=26, mean age 77±7, 50% women) and TMVI as valve-in-valve and valve-in-ring procedures (Group 2, n=29, mean age 71±10, 41% women). LV EDVI decreased stronger in Group 1 (125±34 vs 102±31 ml/m2, p