Transcatheter edge-to-edge repair may benefit selected heart failure patients with disproportionately severe secondary mitral regurgitation, whereas those with proportionate MR have not shown benefit.
Highlights the importance of careful phenotyping to select appropriate candidates with secondary mitral regurgitation for transcatheter edge-to-edge repair.
Secondary mitral regurgitation (MR) is a common and prognostically important complication of heart failure that results from adverse ventricular remodeling rather than intrinsic valve pathology. While optimized heart failure medical therapy remains the foundation of treatment, selected patients with disproportionately severe MR may benefit from transcatheter edge-to-edge repair based on the COAPT trial results. Careful phenotyping to identify appropriate candidates-generally those with severe MR but less extreme ventricular dilatation-is essential, as intervention in patients with proportionate MR has not shown benefit.
Nguyen et al. (Fri,) conducted a review in Secondary mitral regurgitation in advanced heart failure. Transcatheter edge-to-edge repair vs. Optimized heart failure medical therapy was evaluated. Transcatheter edge-to-edge repair may benefit selected heart failure patients with disproportionately severe secondary mitral regurgitation, whereas those with proportionate MR have not shown benefit.