Background

Mitral regurgitation (MR) is one of the most prevalent valvular heart diseases worldwide and is associated with significant morbidity and mortality. Surgical mitral valve repair remains the gold standard treatment; however, many patients are deemed high-risk or ineligible for surgery due to advanced age, comorbidities, or impaired ventricular function. Percutaneous mitral valve repair (PMVR), particularly transcatheter edge-to-edge repair (TEER), has emerged as a minimally invasive alternative.

Objective

To evaluate real-world procedural success, safety, and mid-term clinical outcomes of PMVR in patients with significant symptomatic MR.

Methods

A multicenter observational study was conducted involving 312 consecutive patients undergoing PMVR between January 2020 and December 2024. Clinical, echocardiographic, and procedural data were analyzed. Primary endpoints included procedural success, reduction in MR severity, and all-cause mortality at 12 months.

Results

Mean patient age was 74.8 ± 8.9 years, and 61% were male. Functional MR accounted for 68% of cases. Procedural success was achieved in 95.5% of patients. MR reduction to ≤ Grade 2+ was observed in 89.1% immediately post-procedure and persisted in 83.7% at one year. One-year mortality was 12.5%, while heart failure hospitalization decreased significantly from 1.8 ± 0.7 events/patient/year pre-procedure to 0.6 ± 0.3 events/patient/year post-procedure (p<0.001).

Conclusion

PMVR demonstrates high procedural success and favorable clinical outcomes in real-world practice. The technique offers an effective treatment option for high-risk patients with severe MR who are unsuitable for conventional surgery.