Transcatheter Mitral Valve Repair for Moderate-to-Severe MR

This research constitutes a prospective, single-center, observational study including consecutive patients with functional moderate-to-severe (3+) or severe (4+) MR who underwent TEER in a tertiary center between 2015 and September 2022. Data regarding previous medical history, procedural details, and clinical outcomes were recorded prospectively in a dedicated database. The decision to undergo percutaneous mitral valve repair was taken individually after comprehensive discussion by a Heart Team. The local ethics committee of the center approved data collection and reporting.
All procedures were performed under general anesthesia with the use of fluoroscopic and transesophageal echocardiographic guidance. Briefly, after atrial transseptal puncture, a guiding catheter was placed within the left atrium across the interatrial septum. The device was then steered and aligned over the origin of the regurgitant jet. Then, the mitral leaflets were grasped upon the advancement of the device into the left ventricle and its subsequent retrieval. Finally, the device was closed, and the mitral leaflets were approximated.
The MitraClip system was used for all cases, and the decision on the number of clips to be implanted was left to the discretion of the interventional team based on residual MR, residual mitral valve area, and diastolic mitral gradients.