The impact of residual mitral regurgitation on outcomes in patients with primary mitral regurgitation undergoing mitral valve transcatheter edge-to-edge repair

Abstract Background Mitral valve transcatheter edge-to-edge repair (M-TEER) has become an established therapeutic approach for patients at high surgical risk with relevant mitral regurgitation (MR). While robust data exists on the impact outcome of residual MR (rMR) following M-TEER secondary MR, exact role rMR in primary is currently scarce. This study aimed to investigate adverse outcomes a real-world population undergoing MR. Methods single-center, retrospective analysis includes from 364 consecutive treated by high-volume center between 11/2008–01/2020. Post-procedural was defined as grade determined transthoracic echocardiography before discharge. Primary endpoint all-cause mortality; composite included mortality or rehospitalization heart failure 1-year follow-up. Kaplan-Meier estimates and Cox regression were performed outcomes. Results In this high-risk (mean age 78.6±7.4 years, 55.2% male, median logistic EuroSCORE 17.5% [interquartile range 10.4; 27.7], STS Score 4.4% 2.8; 6.6]), discharge successfully reduced none/mild (≤1+) 191 (52.5%) patients. Moderate (=2+) found 129 (35.4%) moderate-to-severe severe (≥3+) present 44 (12.1%) post-procedurally. Patients rMR≥3+ presented enlarged left atria baseline (left atrium volume: rMR≤1+: 101.8ml (IQR): 77.3, 129.6]; rMR=2+: 113.7ml [IQR: 90.4, 154.3]; rMR≥3+: 123.0ml 92.9, 147.5]; p=0.009) dilated ventricle end-diastolic diameter: 54.8±8.7mm; 59.7±9.8mm; 59.1±10.0mm; p<0.001). Baseline NT-proBNP significantly higher post-precedural compared moderate (p=0.038). analyses demonstrate significant differences endpoints (Figure 1). Compared rMR, rates reported follow-up (rMR≤1+: 16.2%; 23.9%; 40.0%; p[log-rank] = 0.007). Moreover, adjusted cox identified independent predictor (Hazard Ratio 2.70 [95%-confidence interval: 1.12–6.50]; p=0.027). Conclusions Our provides first evidence that clinical impacted post-procedural rMR. analysis, therefore, emphasizes importance minimizing lowest possible order achieve optimal long-term survival. Funding Acknowledgement Type funding sources: None.