Mitral transcatheter edge-to-edge repair: patient selection, current devices, and clinical outcomes

ABSTRACT

Introduction

Over the last two decades, mitral transcatheter edge-to-edge repair (M-TEER) has become a safe and effective therapy for severe mitral regurgitation in patients deemed at high surgical risk.

Areas covered

This review aims to encompass the most relevant and updated evidence in the field of M-TEER from its inception, focusing on clinical and anatomical features for proper patient and device selection.

Expert opinion

Growing operator experience and device iterations have resulted in improved clinical outcomes and an expansion of the therapy to patients with complex anatomies and clinical scenarios. Future investigations are warranted to determine the best management options and the most suitable device for every patient with MR.

KEYWORDS:

• Mitral regurgitation
• transcatheter edge-to-edge repair
• MitraClip
• PASCAL
• heart failure

Article highlights

• The experience and evidence with M-TEER have rapidly increased over the last decade.

• Both MitraClip and PASCAL have proven to be safe and effective, with high procedural success and low rate of procedural complications

• New-generation devices and advanced intraprocedural imaging techniques have expanded the anatomic eligibility for M-TEER

• Patient and device selection remain the cornerstone of M-TEER therapy success

Declaration of interest

CHP Li and D Arzamendi are proctors for Abbott and Edwards. The other authors report no conflicts. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors were involved in the conception and design of the study; AMvR and LA executed data screening and analysis for the review; AMvR and LA produced the original draft writing; all authors reviewed and edited the manuscript for intellectual content; all authors have read and agreed to the published version of the manuscript

Additional information

Funding

This paper received no funding.