Transcatheter edge-to-edge repair for mitral regurgitation

Abstract

Mitral valve transcatheter edge-to-edge repair (M-TEER) has emerged as a transformative therapy for mitral regurgitation (MR), addressing the unmet needs of patients unsuitable for surgery. Landmark trials such as EVEREST II, COAPT, and MITRA-FR have established the safety and efficacy of M-TEER, in both patients with primary (PMR) and secondary MR (SMR). Recent trials, including RESHAPE-HF2 and MATTERHORN, have expanded our understanding and refueled discussions regarding patient selection and appropriate treatment indications in SMR. These trials have also contributed to the discussion regarding SMR phenotypes most appropriate for M-TEER. This review summarizes the evidence from pivotal trials, discusses patient selection, device advancements, potential future directions, and outlines ongoing trials that may shape future clinical practice.

Keywords: M-TEER; MR; Mitral regurgitation; Mitral valve transcatheter edge-to-edge repair; PMR; Primary mitral regurgitation; SMR; Secondary mitral regurgitation.