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Response to: Correspondence on ‘Cost-effectiveness of transcatheter edge-to-edge repair in secondary mitral regurgitation does need confirmation’ by Armoiry and Connock


The Authors’ reply: We thank Drs Armoiry and Connock for their thoughtful comments and questions1 regarding our report on the cost-effectiveness of transcatheter edge-to-edge mitral valve repair (TEER) for patients with heart failure and severe secondary mitral regurgitation (MR) from the perspective of the UK National Health Service.2 They raise two important questions regarding our analysis: the first regarding alternative approaches to life expectancy projection and the second regarding the disparity between the results of the percutaneous repair with the MitraClip device for severe functional/secondary mitral regurgitation (MITRA-FR) and cardiovascular outcomes assessment of the MitraClip percutaneous therapy for heart failure patients with functional mitral regurgitation (COAPT) trials.

The reason why we did not incorporate 3-year follow-up data from the COAPT trial in our projections is straightforward. As described in our paper, after completion of 2-year follow-up, patients randomised to the control group (guideline-directed medical …



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