Background

Functional mitral regurgitation (FMR) is a common complication of heart failure and left ventricular remodeling. Severe FMR is associated with increased mortality, recurrent heart failure hospitalization, and reduced quality of life. Many patients are considered high-risk for surgical intervention because of advanced age, ventricular dysfunction, and multiple comorbidities. Transcatheter mitral valve repair (TMVR), particularly edge-to-edge repair techniques, has emerged as an effective minimally invasive treatment option.

Objective

To evaluate procedural success, clinical outcomes, echocardiographic improvement, and safety of transcatheter mitral repair in patients with functional mitral regurgitation.

Methods

A multicenter retrospective observational study was conducted involving 350 patients with symptomatic moderate-to-severe or severe functional mitral regurgitation who underwent transcatheter mitral repair between January 2020 and December 2025. Clinical, echocardiographic, and procedural outcomes were analyzed over a 12-month follow-up period.

Results

Procedural success was achieved in 95.4% of patients. Significant reduction in mitral regurgitation severity was observed immediately after intervention. At 12 months, heart failure hospitalizations decreased significantly, left ventricular remodeling improved, and quality-of-life scores increased. All-cause mortality at one year was 10.2%.

Conclusion

Transcatheter mitral repair represents a safe and effective treatment option for carefully selected patients with functional mitral regurgitation who remain symptomatic despite guideline-directed medical therapy. Significant improvements in symptoms, ventricular function, and hospitalization rates can be achieved.