Key result
Eccentric residual MR at discharge linked to ~2-fold higher all-cause mortality over 4 years.
Why the study?
Whether the morphology of the residual mitral regurgitation jet affects long-term clinical outcomes after transcatheter edge-to-edge mitral valve repair had not been reported.
Does eccentric residual mitral regurgitation increase the risk of all-cause mortality and heart failure hospitalization in patients who undergo M-TEER?
Cohort (n=125)
No
Does eccentric residual mitral regurgitation increase the risk of all-cause mortality and heart failure hospitalization in patients who undergo M-TEER?
Presence of an eccentric residual mitral regurgitation jet at discharge post-M-TEER is an independent predictor of long-term mortality and heart failure hospitalizations.
Answers are grounded in this paper and cite their sources.
Eccentric residual MR may warrant closer surveillance after M-TEER; leaves open whether jet morphology should guide additional intervention.
Background: More than mild residual mitral regurgitation (MR) is associated with reduced survival after transcatheter edge-to-edge mitral valve repair (M-TEER). However, whether the morphology of the residual MR (rMR) jet affects long-term clinical outcomes has not been reported. The purpose of the study was to assess the impact of eccentric rMR (erMR) at discharge on long-term mortality and heart failure hospitalizations after M-TEER. Methods: We analyzed preprocedural, intraprocedural, and early postprocedural echocardiographic data (1-2 days post-TEER) in patients treated by M-TEER at our institution between 2012 and 2022. Eccentric rMR was defined as a nonsymmetric, wall-hugging MR jet. Conclusions: Presence of erMR at discharge is associated with reduced long-term survival after M-TEER independent of the severity of rMR. Our findings shed light on the importance of preprocedural and intraprocedural planning to avoid eccentric jets and mitigate unfavorable long-term outcomes after M-TEER.
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Schei et al. (2025) conducted a cohort in Significant mitral regurgitation treated by M-TEER (n=125). Eccentric residual mitral regurgitation (erMR) at discharge vs. Absence of eccentric residual mitral regurgitation was evaluated on All-cause mortality (HR 2.01, 95% CI 1.12-3.63, p=0.02). Eccentric residual mitral regurgitation at discharge was associated with a 2-fold higher adjusted risk of all-cause mortality over a median 49-month follow-up.
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