Key result
Pulmonary artery denervation was 100% feasible and safe with no major procedural complications, and immediately reduced median mean pulmonary artery pressure by 4.5 mmHg (p=0.028) in patients with persistent PH post M-TEER.
Why the study?
Persistent pulmonary hypertension after technically successful transcatheter mitral edge-to-edge repair remains associated with symptoms, right ventricular dysfunction, and poor prognosis without an established treatment strategy.
Does pulmonary artery denervation safely improve hemodynamics and functional status in patients with persistent pulmonary hypertension after transcatheter mitral edge-to-edge repair?
Observational (n=6)
No
Does pulmonary artery denervation safely improve hemodynamics and functional status in patients with persistent pulmonary hypertension after transcatheter mitral edge-to-edge repair?
Pulmonary artery denervation represents a novel, safe, and feasible adjunctive catheter-based therapy that may improve hemodynamics and symptoms in carefully selected patients with persistent pulmonary hypertension following successful transcatheter mitral valve edge-to-edge repair.
Should not yet change practice in persistent PH post M-TEER; leaves open confirmation of hemodynamic benefit in larger trials.
Pulmonary hypertension (PH) is common in patients undergoing transcatheter mitral edge‐to‐edge repair (M‐TEER) and is an established determinant of adverse outcomes after intervention. Importantly, persistent PH after technically successful M‐TEER remains associated with ongoing symptoms, right ventricular dysfunction and poor prognosis, yet no dedicated treatment strategy has been established. The aim of this study is to evaluate the safety and efficacy of pulmonary artery denervation (PADN) in patients with persistent PH following successful M‐TEER. Six patients (median age 69.0 years; 1 female) with WHO Group 2 PH and persistent symptoms despite successful M‐TEER underwent PADN at a median of 583 days after valve repair. All patients had trace to mild residual MR (grade 1+) with median mean mitral valve gradient 3.0 mmHg. Right heart catheterization (RHC) was performed at baseline, immediately post‐PADN, and at 6‐month follow‐up. Immediately post‐PADN, mean pulmonary artery pressure (mPAP) decreased from 38.5 (3.8) mmHg to 34.0 (11.5) mmHg ( p = 0.028). Pulmonary arterial wedge pressure decreased from 22.5 (7.5) mmHg to 20.0 (6.2) mmHg ( p = 0.026). At 6‐month follow‐up, a directional but statistically non‐significant trend toward maintained mPAP reduction was observed [median 32.5 (9.0) mmHg vs. baseline 38.5 (3.8) mmHg; p = 0.075]. Tricuspid regurgitation grade improved in 5 of 6 patients (83%). Median 6‐min walk distance increased from 377 (109) m to 436 (109) m ( p = 0.046). No procedural complications occurred. PADN appears feasible, safe, and potentially effective in patients with persistent PH following M‐TEER, warranting further investigation in controlled studies.
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Chen et al. (2026) conducted an observational in Persistent Pulmonary Hypertension After Transcatheter Mitral Edge-to-Edge Repair (n=6). Pulmonary artery denervation was evaluated on Procedural feasibility (successful completion) and safety (absence of major procedure-related complications). Pulmonary artery denervation was 100% feasible and safe with no major procedural complications, and immediately reduced median mean pulmonary artery pressure by 4.5 mmHg (p=0.028) in patients with persistent PH post M-TEER.