Evidence map›Paper›PMID 40908087›Full record

ArticleJACC. Asia2025

A Novel Morphological Classification to Guide Transcatheter Mitral Valve Edge-to-Edge Repair for Commissural Mitral Regurgitation.

Zhi-Nan Lu, Xu-Nan Guo, Yu-Tong Ke, Yihua He, Xianbao Liu, Zhengming Jiang, Xinmin Liu, Wenhui Wu, Yi-Da Tang, Dajun Chai and 5 more

Abstract read
In one paragraph

Article in JACC. Asia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Zhi-Nan LuInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Xu-Nan GuoInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Yu-Tong KeEchocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Yihua HeEchocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Xianbao LiuDepartment of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Zhengming JiangInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Xinmin LiuInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Wenhui WuInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Yi-Da TangDepartment of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.
Dajun ChaiCardiovascular Department, The First Affiliated Hospital, Fujian Medical University, Fujian Institute of Hypertension, Fuzhou, China.
Yansong GuoThird Department of Cardiology, Fujian Provincial Hospital, Fuzhou, Fujian, China.
Yongjian WuNational Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Yat-Yin LamAsian Heart Disease Center, Canossa Hospital, The Chinese University of Hong Kong, Central Medical, Central Building, Hong Kong, China. Electronic address: yylam@me.com.
Nicolo PiazzaMcGill University Health Center, Montreal, Quebec, Canada.
Guangyuan SongInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address: songgy_anzhen@VIP.163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMitral commissural prolapse poses significant anatomical challenges that can hinder the effectiveness of transcatheter edge-to-edge repair (TEER).

objectivesThe aim of this study was to estimate the safety and effectiveness of applying a novel morphological classification to guide TEER in patients with commissural degenerative mitral regurgitation (DMR).

methodsIn this prospective, multicenter study across 18 centers in China, we classified patients with severe commissural DMR into 4 morphological types through detailed echocardiographic analysis. Customized TEER strategies were applied accordingly. Procedural success, clinical outcomes, echocardiographic parameters, and quality of life were assessed over a follow-up period, with a median follow-up of 18 months (Q1-Q3: 15-21 months).

resultsAmong 540 patients screened, 126 (23.3%) exhibited commissural involvement. Tailored TEER strategies were successfully applied to 68 patients, achieving a technical success rate of 100% (n = 68 of 68; 95% CI: 0.933-1.000) and a device success rate of 97.1% (n = 66 of 68, 95% CI: 0.888-0.992). The 1-year follow-up revealed that 94.1% (n = 64 of 68; 95% CI: 0.849-0.981) of patients had residual mitral regurgitation of grade ≤2+, with 82.4% (n = 56 of 68; 95% CI: 0.708-0.902) at grade ≤1+, and no major complications. Additionally, significant improvements were noted in left ventricular dimensions and functional status.

conclusionsOur results highlight the value of the morphological classification system in enhancing TEER for commissural DMR. By addressing specific anatomical challenges, this system promotes tailored interventions that optimize procedural success and improve patient outcomes.

Indexed as

commissural prolapseheart failuremitral regurgitationmorphologicaltranscatheter edge-to-edge repair

Identifiers

PMID40908087
PMCPMC12426676

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.