https://doi.org/10.1007/s00392-025-02625-4
1Universitätsklinikum Tübingen Innere Medizin III, Kardiologie und Angiologie Tübingen, Deutschland; 2Universitätsklinikum Ulm Klinik für Innere Medizin II Ulm, Deutschland; 3Universitätsklinikum Tübingen Innere Medizin III, Kardiologie und Kreislauferkrankungen Tübingen, Deutschland
Background: Mitral transcatheter edge-to-edge repair (M-TEER) has been established as a standard treatment for severe mitral regurgitation (MR). Despite its widespread adoption, patients undergoing this procedure show high mortality rates. Therefore, we aimed to investigate if residual MR and clinical covariates were independently associated with all-cause mortality (ACM) after M-TEER.
Methods and results: This is a retrospective observational study. We enrolled 818 patients, that were treated with the Abbott MitraClip™ device between 2010 and 2023 at our university hospital. All patients were followed-up for 360 days for the outcome ACM. We observed that 1-year mortality was significantly lower in patients with MR grade 1 or lower after M-TEER (14.7% vs 22.9%). Multivariable Cox regression analysis revealed that, besides residual MR, gender, diabetes, and EuroSCORE II were independently associated with ACM. Of note, age, arterial hypertension, active smoking, dyslipidaemia, MR aetiology, left ventricular ejection fraction (LVEF%) and systolic pulmonary artery pressure (PAPsys) did not show independent associations with the respective outcome.
Conclusion: The current study indicates that 1-year mortality following M-TEER is significantly affected by several key factors including gender, diabetes and EuroSCORE II. Patients with lower EuroSCORE II, female gender, absence of diabetes mellitus, and post-procedural mitral regurgitation grade 1 or lower demonstrate a notably reduced mortality risk. These findings suggest that M-TEER represents an interventional strategy that may drastically improve prognosis in this severely ill and otherwise difficult to treat patient collective.