Transcatheter Edge-to-Edge Repair for Mitral Regurgitation – Real World Experience from an Irish Centre

Abstract

Transcatheter edge-to-edge repair (TEER) is an established therapy for primary and secondary mitral regurgitation (MR) in patients with severe symptoms, and high or prohibitive surgical risk. We aimed to evaluate procedural and clinical outcomes of mitral TEER at our centre. All patients undergoing mitral valve (MV) TEER between July 2013 and April 2025 were prospectively enrolled in a dedicated registry. Baseline characteristics, procedural data, and outcomes were analyzed. 99 patients underwent MV TEER. Mean age was 76.4 ± 11.4 years; 67% were male. Atrial fibrillation and hypertension were present in 62% and 48%, respectively. Left ventricular function was normal in 50%, moderately impaired in 38%, and poor in 12%. MR was classified as primary in 44%, secondary in 44%, and mixed or other in 12%. TEER was successfully performed in 92 (93%) patients using MitraClip (58%) or Pascal (42%). In 86% of these patients, post-procedural MR was mild or less. In 7 patients, a TEER device was not deployed due to anatomical or haemodynamic limitations. Mean procedural and fluoroscopy times were 126 ± 48 and 31 ± 18 minutes, respectively. Median hospital stay was 3 days. There were no in-hospital deaths. Repeat TEER was performed in 5 patients. Kaplan-Meier analysis demonstrated survival rates of 85.7% at 1 year, 58.8% at 3 years, and 40.6% at 5 years, over a median follow-up of 1.5 years. MV TEER is safe, effective, and associated with high procedural success in a high-risk population. Long-term follow-up is essential to evaluate durability.