Temporal trends in mitral edge-to-edge repair for primary mitral regurgitation.
Publisher DOI
PubMed ID
42290314
Abstract
Background
The evolving landscape of mitral valve transcatheter edge-to-edge repair (M-TEER) for mitral regurgitation (MR) has seen continuous advancements, driving improvements in therapeutic efficacy. Particularly in primary MR (PMR), contemporary device iterations of M-TEER offer technical advantages for improved management of complex anatomies. However, data on temporal trends in M-TEER for PMR are limited.
Aims
The primary objective of our study was to analyse temporal trends in the safety, efficacy, and stability of M-TEER treatment.
Methods
The PRIME-MR registry, a retrospective multicentre study, enrolled consecutive patients undergoing M-TEER for PMR at 27 centres in Europe and North America. M-TEER procedures were categorised into four time periods (2009-2013, 2014-2016, 2017-2019, and 2020-2023), to align with major device updates.
Results
The analysis included 3,082 consecutive patients (median age 82 years [interquartile range 76.0-85.0], 45.1% female). Patients treated were highly symptomatic (New York Heart Association [NYHA] Class ≥III in 80.4%). Patient characteristics showed a decline in symptomatic severity (NYHA Class ≥III 85.9% in 2009-2013 vs 71.8% in 2020-2023), accompanied by lower mean Society of Thoracic Surgeons scores (5.6% [2009-2013] vs 4.6% [2020-2023]; p for trend<0.0001), and less severe MR. Over time, complication rates decreased (procedures with complications: 42.4% [2009-2013] vs 23.1% [2020-2023]; p for trend<0.0001), whereas technical efficacy increased (residual MR ≤1+: 54.0% [2009-2013] vs 68.4% [2020-2023]; p for trend<0.001). There was an increased occurrence of stable results without any deterioration at one-year follow-up (63.6% [2009-2013] vs 74.4% [2020-2023]; p for trend=0.03).
Conclusions
Findings from the PRIME-MR registry highlight substantial reductions in residual MR severity and complication rates over time in PMR patients undergoing M-TEER.
The evolving landscape of mitral valve transcatheter edge-to-edge repair (M-TEER) for mitral regurgitation (MR) has seen continuous advancements, driving improvements in therapeutic efficacy. Particularly in primary MR (PMR), contemporary device iterations of M-TEER offer technical advantages for improved management of complex anatomies. However, data on temporal trends in M-TEER for PMR are limited.
Aims
The primary objective of our study was to analyse temporal trends in the safety, efficacy, and stability of M-TEER treatment.
Methods
The PRIME-MR registry, a retrospective multicentre study, enrolled consecutive patients undergoing M-TEER for PMR at 27 centres in Europe and North America. M-TEER procedures were categorised into four time periods (2009-2013, 2014-2016, 2017-2019, and 2020-2023), to align with major device updates.
Results
The analysis included 3,082 consecutive patients (median age 82 years [interquartile range 76.0-85.0], 45.1% female). Patients treated were highly symptomatic (New York Heart Association [NYHA] Class ≥III in 80.4%). Patient characteristics showed a decline in symptomatic severity (NYHA Class ≥III 85.9% in 2009-2013 vs 71.8% in 2020-2023), accompanied by lower mean Society of Thoracic Surgeons scores (5.6% [2009-2013] vs 4.6% [2020-2023]; p for trend<0.0001), and less severe MR. Over time, complication rates decreased (procedures with complications: 42.4% [2009-2013] vs 23.1% [2020-2023]; p for trend<0.0001), whereas technical efficacy increased (residual MR ≤1+: 54.0% [2009-2013] vs 68.4% [2020-2023]; p for trend<0.001). There was an increased occurrence of stable results without any deterioration at one-year follow-up (63.6% [2009-2013] vs 74.4% [2020-2023]; p for trend=0.03).
Conclusions
Findings from the PRIME-MR registry highlight substantial reductions in residual MR severity and complication rates over time in PMR patients undergoing M-TEER.
Date Issued
2026
Publication Type
Article
Subject(s)
Language(s)
en
Author(s)
Koell, Benedikt | |
Ludwig, Sebastian | |
Weimann, Jessica | |
Patel, Dhairya | |
Stolz, Lukas | |
Tanaka, Tetsu | |
Trenkwalder, Teresa | |
von Stein, Philipp | |
Giannini, Cristina | |
Dreyfus, Julien | |
Scotti, Andrea | |
Paradis, Jean-Michel | |
Adamo, Marianna | |
Karam, Nicole | |
Bohbot, Yohann | |
Bernard, Anne | |
Melica, Bruno | |
Kobari, Yusuke | |
Lavie-Badie, Yoan | |
Kessler, Mirjam | |
Chehab, Omar | |
Redwood, Simon | |
Lubos, Edith | |
de Backer, Ole | |
Metra, Marco | |
Latib, Azeem | |
Primerano, Chiara | |
Iliadis, Christos | |
Gerçek, Muhammed | |
Xhepa, Erion | |
Weber, Marcel | |
Makkar, Raj | |
Granada, Juan | |
Modine, Thomas | |
Donal, Erwan | |
Hausleiter, Jörg | |
Coisne, Augustin | |
Kalbacher, Daniel | |
Prime-Mr Investigators, On Behalf Of The |
Additional Credits
Journal
EuroIntervention
Publisher
Europa Group
ISSN
1969-6213
Access(Rights)
metadata.only