Key result
Mitral TEER aborted after transmitral mean pressure gradient spikes to ~9 mmHg, causing functional stenosis.
Why the study?
Mitral valve transcatheter edge-to-edge repair is effective for ventricular functional mitral regurgitation, but increasing transmitral mean pressure gradient is a critical complication to consider.
Case Report (n=1)
No
M-TEER can cause hemodynamically significant functional mitral stenosis requiring procedural abortion even when preprocedural mitral valve orifice area appears adequate, highlighting the need to evaluate annular geometry and leaflet morphology.
Unexpected gradient rise may abort M-TEER; leaves open need for refined preprocedural predictors in functional MR.
Objective: Mitral valve transcatheter edge-to-edge repair (M-TEER) is a highly effective therapeutic option for patients with ventricular functional mitral regurgitation (FMR). However, an increasing transmitral mean pressure gradient (TMPG) is a potential complication that must always be considered. Here, we report a case in which critically severe, hemodynamically significant mitral stenosis (MS) could not be avoided, leading to procedural abortion.
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Kojima et al. (2026) conducted a case report in Functional mitral regurgitation (n=1). Mitral valve transcatheter edge-to-edge repair (MitraClip) was evaluated on Transmitral mean pressure gradient (TMPG). Mitral valve transcatheter edge-to-edge repair was aborted due to an unpredictable and unacceptable increase in transmitral mean pressure gradient to 9.1 mmHg, causing functional mitral stenosis.
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