JACC. Cardiovascular interventions · 2026
Durability of Mitral Valve Transcatheter Edge-to-Edge Repair: An Expert Overview.
СтатьяОбзорПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Mariani Andrea, Stolz Lukas, von Bardeleben Ralph Stephan, Treede Hendrik, Modine Thomas, Kardys Isabella, Latib Azeem, Lim D Scott, Hausleiter Jörg, Van Mieghem Nicolas M
Аннотация
BACKGROUND: Mitral regurgitation (MR) is a globally endemic heart disease burden with significant morbidity and mortality. Mitral transcatheter edge-to-edge repair (M-TEER) has emerged as a minimally invasive treatment with established safety and intermediate-term efficacy.
OBJECTIVES: The aim of this study was to determine M-TEER durability and the incidence, risk factors, and treatment strategies of M-TEER failure.
METHODS: A comprehensive literature review was performed, identifying 457 records, from which 33 full-text papers were included. Definitions of MR recurrence, reintervention, and M-TEER durability and failure were provided. On the basis of these definitions, weighted means with 95% CIs were calculated for the rates of MR recurrence, reintervention, and their composite for both the overall population and the primary and secondary MR subgroups.
RESULTS: The pooled weighted means of MR recurrence and reintervention ranged between 5% and 10% in the first months after the index procedure, remained relatively stable for the first 3 years, and increased at 5 years to 17% and 9%, respectively. MR recurrence and reintervention weighted means were numerically higher in primary than secondary MR, and 41% of primary MR patients experienced MR recurrence or reintervention at 5 years. Redo transcatheter edge-to-edge repair for M-TEER failure seemed safer than surgery but was associated with 1-year MR recurrence rates between 20% and 40%. Mitral valve replacement was the most common surgical technique for M-TEER failure.
CONCLUSIONS: The incidence of M-TEER failure after a successful index procedure increases after 3 years and is more pronounced with primary than secondary MR. More systematic, longer term follow-up data after M-TEER are required to better define M-TEER durability.
OBJECTIVES: The aim of this study was to determine M-TEER durability and the incidence, risk factors, and treatment strategies of M-TEER failure.
METHODS: A comprehensive literature review was performed, identifying 457 records, from which 33 full-text papers were included. Definitions of MR recurrence, reintervention, and M-TEER durability and failure were provided. On the basis of these definitions, weighted means with 95% CIs were calculated for the rates of MR recurrence, reintervention, and their composite for both the overall population and the primary and secondary MR subgroups.
RESULTS: The pooled weighted means of MR recurrence and reintervention ranged between 5% and 10% in the first months after the index procedure, remained relatively stable for the first 3 years, and increased at 5 years to 17% and 9%, respectively. MR recurrence and reintervention weighted means were numerically higher in primary than secondary MR, and 41% of primary MR patients experienced MR recurrence or reintervention at 5 years. Redo transcatheter edge-to-edge repair for M-TEER failure seemed safer than surgery but was associated with 1-year MR recurrence rates between 20% and 40%. Mitral valve replacement was the most common surgical technique for M-TEER failure.
CONCLUSIONS: The incidence of M-TEER failure after a successful index procedure increases after 3 years and is more pronounced with primary than secondary MR. More systematic, longer term follow-up data after M-TEER are required to better define M-TEER durability.