Valvular & structural heart disease
Impact of mitral valve complexity on outcomes following transcatheter mitral valve edge-to-edge repair
Authors' conclusion
This study provides the first large-scale validation of a recently proposed mitral valve complexity framework. Anatomical complexity showed an etiology-specific impact, with no relevant effect on MR reduction or clinical outcomes in SMR, but increasing residual MR in primary disease. Given an acceptable rate of MR reduction, M-TEER can even be considered in selected patients with unfavourable MV anatomy as ‘ultima ratio’.
Study context
- Population
- Patients who underwent M-TEER, categorized by mitral valve anatomical complexityconsecutive patients, mean age 74.9 ± 11.1 years, 42.7% female, 49% with secondary and 51% with primary or mixed mitral valve (MV) disease
- Participants
- 789 patients
- Exposure
- Patient outcomes according to mitral valve anatomical complexity
- Non-Complex (NC)n = 203
- Complex (C)n = 409
- Very Complex (VC)n = 138
- Ultimately Complex (UC)n = 39
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Improvement to New York Heart Association (NYHA) functional class ≤ II
- Comparable across anatomical complexity groups
- P = 0.454
Observational data: associations, not effects.
Further findings
Survival · 2 years
Residual MR ≥3 + in primary MR
- Survival — Comparable across anatomical complexity groups
- P = 0.454
- Residual MR ≥3 + in primary MR — Increasing MV complexity was associated with an increasing prevalence of residual MR ≥3 + in primary MR
- P = 0.002
MR reduction
- MR reduction was observed in all categories and it was comparable in secondary MV disease
Original publication
Impact of mitral valve complexity on outcomes following transcatheter mitral valve edge-to-edge repair. Eur Heart J Cardiovasc Imaging. Published 29 January 2026. doi:10.
Summarised from the published abstract; every number is checked against it