Mitral Transcatheter Edge-to-Edge Repair in Patients With Advanced Heart Failure: A Single-Center Experience and...

Advanced heart failure (HF) remains a clinical challenge, and mitral transcatheter edge-to-edge repair (M-TEER) has emerged as a potential bridging strategy.

To describe the clinical outcomes of M-TEER in a single-center cohort of patients with advanced HF and to identify anatomical and clinical features potentially associated with increased procedural complexity.

This retrospective case series included 13 consecutive patients with advanced HF and moderate-to-severe or severe mitral regurgitation (MR) who underwent M-TEER using the MitraClip system. Clinical, echocardiographic, and hemodynamic data were analyzed.

The median age was 58 years (range 39-64), and the median EuroSCORE II was 10.4% (3.86-15.07). All patients had reduced left ventricular (LV) ejection fraction (median 22%) and enlarged LV dimensions (end-systolic diameter > 70 mm in 38%). The mean tenting height was 15.4 ± 2.5 mm. Five patients (38.4%) required continuous inotropic support. Procedural success was achieved in all cases, with no periprocedural or 30-day mortality. Over a median follow-up of 287 days (171-483), four patients (30.7%) died, one (7.6%) underwent urgent heart transplantation, and two (15.3%) had elective transplantation. Four of five patients on inotropes (80%) were weaned off support. At 1 year, 61.5% of patients remained free from the composite endpoint of death, HF hospitalization, urgent transplant, or LV assist device implantation.

M-TEER was feasible and safe in selected patients with advanced HF. This cohort presented anatomical and clinical features that may have contributed to greater procedural complexity.