Clinical Failure After Mitral Transcatheter Edge-to-Edge Repair Mechanisms, Outcomes, and Management.

Transcatheter repair with edge-to-edge therapy (M-TEER) has been a revolutionary technology for patients with mitral regurgitation (MR). M-TEER is an established safe and effective treatment that alleviates MR, improves quality of life, and, in some patients, improves survival. Nonetheless, a significant number of M-TEER may not have procedural nor clinical success due to a variety of factors, with residual MR and/or mitral stenosis. The clinical manifestation of M-TEER failures may be early or late, with varying degrees of patient impact, ranging from an asymptomatic state to heart failure and poor survival. Because M-TEER patients typically are elderly and with significant morbidity, the management of these clinical failures poses vexing clinical challenges. Herein, we review the incidence and factors that contribute to M-TEER failure, as well as the associated clinical outcomes and management strategies.