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Transcatheter Edge-to-Edge Repair for SAM-Related Mitral Regurgitation in Patients With HCM: The TRANSPARENT Registry

Luca Testa1, Luca Arzuffi1, Antonio Popolo Rubbio1

  • 1Cardiology Department, IRCCS Policlinico San Donato, Milan, Italy.

JACC. Cardiovascular Interventions
|October 28, 2025
PubMed

Insights

Transcatheter mitral edge-to-edge repair (M-TEER) shows promise for treating obstructive hypertrophic cardiomyopathy (HCM) with significant mitral regurgitation. This minimally invasive procedure effectively reduces left ventricle outflow tract obstruction and improves symptoms in high-risk patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart condition causing left ventricular hypertrophy, outflow tract obstruction, and mitral regurgitation.
  • Transcatheter mitral edge-to-edge repair (M-TEER) is being explored for high-risk patients, but its efficacy and safety in obstructive HCM are not fully established.

Purpose of the Study:

  • To evaluate the safety and efficacy of M-TEER in patients with obstructive HCM and moderate-to-severe or severe systolic anterior motion (SAM)-related mitral regurgitation (MR).

Main Methods:

  • A retrospective, international, multicenter study involving 35 symptomatic patients undergoing M-TEER.
  • Outcomes were assessed using MVARC definitions, including echocardiographic and clinical parameters at various follow-up points.

Main Results:

  • High rates of technical (94%), device (91%), and procedural (88%) success were observed.
  • Significant reduction in left ventricle outflow tract (LVOT) gradient persisted long-term, with 97% achieving MR <2.
  • Symptomatic improvement was notable, with NYHA class I/II increasing from 31% to 88% at last follow-up.

Conclusions:

  • M-TEER is a feasible and safe option for select patients with obstructive HCM, LVOTO, and SAM-related MR who are poor surgical candidates.
  • Further large-scale studies are needed to confirm the long-term role of M-TEER in this specific patient population.
Abstract

Keywords:
HCMM-TEERmitral regurgitationsystolic anterior motion

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