Clinical Outcomes With Transcatheter Edge-to-Edge Repair in Atrial Functional MR From the EXPAND Study

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Transcatheter edge-to-edge repair (TEER) improves outcomes for secondary mitral regurgitation (SMR) with left ventricular dysfunction.
• The impact of TEER on atrial SMR (aSMR) remains less understood.

Purpose of the Study:

• To evaluate the safety, echocardiographic results, and clinical effectiveness of TEER specifically for patients with aSMR.

Main Methods:

• The study analyzed data from the prospective, observational, multicenter EXPAND registry.
• Echocardiography core laboratory identified patients with aSMR.
• Follow-up included assessments at discharge, 30 days, and 1 year, focusing on MR severity, functional class, heart failure hospitalizations, and mortality.

Main Results:

• TEER significantly reduced MR in the aSMR cohort, achieving MR grade ≤2 in 100% at 1 year.
• Patients experienced a significant improvement in quality of life (Kansas City Cardiomyopathy Questionnaire score +26.6 points) and functional class.
• Outcomes were comparable to patients with ventricular SMR (vSMR), with infrequent major adverse events.

Conclusions:

• TEER is safe and effective for treating aSMR in a real-world setting.
• The procedure leads to significant MR reduction and improved quality of life and functional class.
• TEER offers clinical benefits for patients with atrial fibrillation and SMR, including those with heart failure with preserved ejection fraction.