Key result
M-TEER for non-central vs central pMR yields 10% discharge residual MR but less 12-month worsening.
Why the study?
It remained unclear whether M-TEER ensures procedural safety and 30-day and 1-year efficacy in non-central pMR compared to central pMR.
Does transcatheter edge-to-edge mitral valve repair provide similar safety and echocardiographic efficacy in non-central primary mitral regurgitation compared to central primary mitral regurgitation?
Cohort (n=129)
No
Does transcatheter edge-to-edge mitral valve repair provide similar safety and echocardiographic efficacy in non-central primary mitral regurgitation compared to central primary mitral regurgitation?
Absolute Event Rate: 10% vs 0.8%
p-value: p=0.01
M-TEER for non-central primary mitral regurgitation is safe and, despite worse initial residual MR compared to central pMR, demonstrates better sustained MR reduction at 1 year.
Supports M-TEER feasibility in non-central pMR; leaves open durability advantage pending randomized confirmation.
Background It remains unclear whether transcatheter edge-to-edge mitral valve repair (M-TEER) ensures procedural safety and 30-day and one-year efficacy in non-central primary mitral regurgitation (pMR) compared to central pMR. Objectives This study assessed clinical and echocardiographic outcomes of M-TEER in non-central pMR compared with central pMR. Methods This study included consecutive patients with pMR who underwent M-TEER at a single center between April 2018 and December 2022. Data were prospectively collected and analyzed retrospectively. Baseline clinical and echocardiographic characteristics, as well as procedural and clinical outcomes up to 1-year post procedure, were compared between patients with non-central pMR group (NCpMR) and those with central pMR group (CpMR). Results Among 129 patients with pMR who underwent M-TEER, 50 had NCpMR and 79 had CpMR. Neither group had 30-day mortality. Although residual MR grade 3+/4+ was more frequent in NCpMR than CpMR (10.0% vs. 0.8%, p = 0.01), MR worsening was lower in NCpMR at 6 months (5.0% vs. 10.5%, p = 0.18) and 12 months (7.5% vs. 27.7%, p = 0.03). A 30-day landmark analysis showed a trend towards a lower prevalence of residual MR grade 3+/4+ at 1 year in NCpMR (p = 0.051). Conclusions No significant differences in 30-day mortality and emergent intervention for complications were noted among two groups. Although MR grade at discharge was better in CpMR, NCpMR showed lower MR worsening and sustained MR reduction at 1-year. M-TEER can be an option for non-central pMR in high-risk surgical patients.
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Enta et al. (2025) conducted a cohort in Primary Mitral Regurgitation (n=129). Transcatheter edge-to-edge mitral valve repair (M-TEER) for non-central pMR vs. M-TEER for central pMR was evaluated on Residual MR grade 3+/4+ at discharge (p=0.01). M-TEER for non-central primary mitral regurgitation resulted in a higher rate of residual MR grade 3+/4+ at discharge compared to central pMR (10.0% vs. 0.8%), but showed significantly lower MR worsening at 12 months (7.5% vs. 27.7%).
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