Transcatheter Repair versus Mitral-Valve Surgery for Secondary Mitral Regurgitation

To the Editor: In the Multicenter Mitral Valve Reconstruction for Advanced Insufficiency of Functional or Ischemic Origin (MATTERHORN) trial, Baldus et al. (Nov. 14 issue) 1 found that transcatheter edge-to-edge repair was noninferior to mitral-valve surgery with respect to a composite end point of death, rehospitalization for heart failure, stroke, reintervention, or implantation of a left ventricular assist device among patients with heart failure and secondary mitral regurgitation. However, we have some concerns. First, although the authors state that patients were eligible if they had persistent heart failure despite guideline-directed therapy, considerable discrepancies exist in the utilization of medical therapy between . . .