Valvular & structural heart disease

Mitral Transcatheter Edge-to-Edge Repair in Ventricular Functional Mitral Regurgitation and Very Severe Left Ventricular Dysfunction

JACC AdvPublished prospective registry

Main finding · Composite of all-cause death and heart failure (HF) hospitalizationResult — go to the resultHazard ratio 1.24 95% CI 0.82–1.88

Authors' conclusion

In patients with ventricular functional MR and LVEF <20%, M-TEER was feasible and associated with meaningful symptomatic improvement without excess risk of death or HF hospitalization, although CV mortality remained higher, likely reflecting advanced myocardial disease.

Study context

Population
Patients with functional mitral regurgitation (MR) and LVEF ≤40% undergoing mitral transcatheter edge-to-edge repair (M-TEER)patients with functional MR and LVEF ≤40%
Participants
1,538 patients
Exposure
LVEF <20% vs 20%≤ LVEF ≤40%
  • LVEF <20%n = 103
  • 20%≤ LVEF ≤40%n = 1,435reference
Outcome
Composite of:
  • All-cause death
  • Heart failure (HF) hospitalization
Follow-up
1 year

Main finding

As reported in the abstract

Hazard ratio

1.24

95% CI 0.82–1.88

LVEF <20%vs 20%≤ LVEF ≤40%
HR 1.24 (95% CI 0.82–1.88)

Observational data: associations, not effects.

Secondary outcomes

Acute procedural success

In-hospital mortality · did not differ by LVEF category

OutcomeHR (95% CI)
CV mortalityIndependently associated2.00 (1.08–3.68)

Acute procedural success

Comparable residual MR and postprocedural transmitral pressure gradients

NYHA functional class · 1 year

Significant improvement in both groups; functional status remained worse in patients with LVEF <20%

Original publication

Mitral Transcatheter Edge-to-Edge Repair in Ventricular Functional Mitral Regurgitation and Very Severe Left Ventricular Dysfunction. JACC Adv. Published 14 August 2026. doi:10.1016/j.jacadv.2026.103126

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