Impact of Recurrent Mitral Regurgitation Following Mitral Transcatheter Edge-to-Edge Repair on Long-Term Outcomes

Pauschinger, C; Koell, B; Heinze, A; Schirmer, J; Girdauskas, E; Waldschmidt, L; Ludwig, S; Plewe, L; Steinhoff, L; Schaefer, A; Blankenberg, S; Schofer, N; Kalbacher, D

doi:10.1016/j.jcin.2026.07.015

Valvular & structural heart disease

Impact of Recurrent Mitral Regurgitation Following Mitral Transcatheter Edge-to-Edge Repair on Long-Term Outcomes

JACC Cardiovasc IntervPublished 26 Oct 2026retrospective cohort

Main finding · All-cause mortalityResultHazard ratio 1.43 95% CI 1.06–1.93

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Authors' conclusion

recMR is common and independently associated with increased mortality after M-TEER, with a more pronounced effect in patients with DMR. Identification of patients at risk may inform closer surveillance and timely reintervention.

Study context

Population: Patients with mitral regurgitation (MR) undergoing successful mitral transcatheter edge-to-edge repair (M-TEER) (residual mitral regurgitation ≤2+ at discharge) between 2008 and 2021consecutive patients with successful M-TEER · functional mitral regurgitation (FMR) 326 · degenerative mitral regurgitation (DMR) 135
Participants: 461 patients

Exposure: Patients with recurrent mitral regurgitation (recMR) vs without recMR after successful M-TEER
recMRn = 146
Outcome: All-cause mortality
Follow-up: 4 years

Methodological detailsconsecutive patients, 12-month landmark analysis, multivariable Cox regression

Consecutive patients
12-month landmark analysis
Multivariable Cox regression

Main finding

As reported in the abstract

Hazard ratio

1.43

95% CI 1.06–1.93

P = 0.019

By group

Without recMR44.8%95% CI 38.7%–50.3%

recMR56.3%95% CI 47.2%–63.9%

Patients with recMRvs without recMR after successful M-TEER

HR 1.43 (95% CI 1.06–1.93); P = 0.019

Observational data: associations, not effects.

Further findings

Survival, 12-month landmark analysis

Absence of recMR associated with improved survival (log-rank): P = 0.0088

Survival by MR aetiology

DMR: survival difference significant (log-rank): P = 0.014
FMR: survival difference not significant: P = 0.11

Incidence of recMR

recMR overall: 31.7% (146 of 461)
recMR among FMR: 31.9% [104 of 326]
recMR among DMR: 31.1% [42 of 135]
Median follow-up: 3.44 years (Q1-Q3: 1.51-3.99 years)

Original publication

Impact of Recurrent Mitral Regurgitation Following Mitral Transcatheter Edge-to-Edge Repair on Long-Term Outcomes. JACC Cardiovasc Interv. Published 26 October 2026. doi:10.1016/j.jcin.2026.07.015

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