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Updated: Sep 19, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Meta-analysis of transcatheter edge-to-edge repair vs surgery for secondary mitral regurgitation
Sahib Singh1, Muhammad Asim Shabbir2, Nidhish Tiwari2
1Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Background:
Transcatheter edge-to-edge repair (TEER) in patients with secondary mitral regurgitation (MR) has shown variable outcomes in clinical studies when compared with mitral valve surgery. We conducted a meta-analysis to reconcile the data.
Methods:
Online databases were searched for studies assessing TEER vs surgery for secondary MR. The outcomes of interest were length of hospital stay, all deaths, heart failure (HF) rehospitalization, mitral valve reintervention, implantation of left ventricular assist device (LVAD), stroke and recurrence of grade 3 or 4 MR. Pooled odds ratios (OR) and standardized mean difference (SMD), with 95 % confidence intervals (CI) were calculated.
Results:
Eight studies (1 randomized and 7 observational) with a total of 1436 patients (TEER n = 826, surgery n = 610) were included. Length of hospital stay was shorter in the TEER group (SMD -2.50, 95 % CI -4.65 to -0.35, p = 0.02). No significant differences were found between the two groups with respect to all deaths (p = 0.80), HF rehospitalization, mitral valve reintervention, implantation of LVAD and stroke. Recurrence of grade 3 or 4 MR was higher in the TEER group (OR 5.33, 95 % CI 2.57 to 11.03, p < 0.00001).
Conclusions:
In patients with secondary MR, TEER and surgery have comparable outcomes such as mortality, except for the lower recurrence of grade 3 or 4 MR in the surgical group. Thus, TEER may be the first approach in such patients, except in low surgical risk cases who need other concomitant cardiac surgeries.
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