ArticleStructural heart : the journal of the Heart Team2026
Midterm Outcomes of Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation According to Anatomical Characteristics.
Article in Structural heart : the journal of the Heart Team, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Mitral transcatheter edge-to-edge repair (M-TEER) is an established option for high-risk primary mitral regurgitation (PMR) patients, but data on the impact of anatomical complexity on prognosis are scarce and conflicting. Objectives: The aims of this study were to characterize patients with severe PMR undergoing M-TEER, assess mid-term prognosis after M-TEER, and identify prognostic factors based on PMR mechanism. Methods: Data from symptomatic PMR patients with severe PMR treated with M-TEER between July 2013 and October 2023 at two Swiss centers were collected retrospectively until 2017 and prospectively thereafter. Patients were categorized by lesion type: A2-P2 prolapse/flail vs. non-A2-P2 prolapse/flail. A subset was classified by mitral valve (MV) anatomical complexity (defined by the presence of ≥1 of the following: ≥moderate calcifications, Barlow's disease, multiple prolapses, or commissural prolapses). Cox regression identified predictors of 1-year all-cause mortality. Results: Among 315 patients (mean age 82.2 ± 6.3 years, 46.3% female, European System for Cardiac Operative Risk Evaluation II 5.1% ± 4.1%) followed for a median (interquartile range [IQR]) of 13 months (5-33), technical success was 93.0%. Compared with the non-A2-P2 prolapse/flail group (n = 186), the A2-P2 prolapse/flail group (n = 129) had better echocardiographic outcomes at discharge (residual mitral regurgitation [MR] ≤ 1+: 70.5 vs. 60.4%; Conclusions: MV anatomical characteristics have a significant influence on symptomatic improvement and all-cause mortality at 1 year and should be carefully considered during the selection of PMR patients for M-TEER.
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