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Determinants and Prognostic Impact of Residual Mitral Regurgitation After Transcatheter Edge-to-Edge Repair
Session:
Sessão de Posters 41 - Intervenções estruturais cardíacas e resultados
Speaker:
Catarina Santos-Jorge
Congress:
CPC 2026
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
C. Santos-Jorge; Rita Barbosa Sousa; Débora Silva Correia; Márcia Presume; Marisa Trabulo; Afonso Félix de Oliveira; Pedro Gonçalves; Eduardo Infante Oliveira; João Brito; Regina Ribeiras; Rui Campante Teles; Manuel Almeida
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="color:black">Background:</span></strong><br /> <span style="color:black">Percutaneous edge-to-edge (E2E) transcatheter mitral repair has become an established therapeutic option for patients with moderate-to-severe or severe mitral regurgitation (MR) who are at high surgical risk. Long-term clinical outcomes and predictors of adverse events remain incompletely defined. This study aimed to characterize a real-world cohort undergoing E2E mitral repair and to identify clinical and echocardiographic factors associated with mortality and heart failure (HF) hospitalization after the procedure.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="color:black">Methods:</span></strong><br /> <span style="color:black">We retrospectively evaluated 107 consecutive patients deemed eligible and treated with transcatheter E2E mitral repair between 2015 and 2025 at a single center. Clinical, echocardiographic, and procedural data were collected and analyzed.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="color:black">Results:</span></strong><br /> <span style="color:black">The median age was 77 years (IQR 69–82), and 66 (61.7%) were male. Ischemic etiology was present in 20 (18.7%) cases, and secondary MR in 66 (61.7%). Most patients were in advanced functional class </span><span style="font-family:Symbol">[</span><span style="color:black">New York Heart Association (NYHA) III–IV, 68.3%</span><span style="font-family:Symbol">]</span><span style="color:black"> and under diuretic therapy (n=92, 86%). The median left ventricular ejection fraction was 45% (IQR 36–55), and NT-proBNP levels were 2483 pg/mL (IQR 1090–6569). Following the intervention, MR reduction to mild was achieved in 60 (64.5%) patients. At one-year follow-up, 27 (25.2%) had required hospitalization for HF and 18 (16.8%) had died. Higher pre-procedural effective regurgitant orifice area (EROA;</span> <em><span style="color:black">p</span></em> <span style="color:black">=0.045) and left ventricular end-diastolic volume (</span><em><span style="color:black">p</span></em><span style="color:black">=0.029) were independently associated with more severe post procedural MR, as was the presence of atrial fibrillation (</span><em><span style="color:black">p</span></em><span style="color:black">=0.048). Increasing residual MR severity was significantly related to both HF hospitalization (</span><em><span style="color:black">p</span></em><span style="color:black">=0.013) and all-cause mortality (</span><em><span style="color:black">p</span></em><span style="color:black">=0.029). </span>Increasing MR severity independently predicted higher NYHA classification and therefore worse functional status (p = 0.004). </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="color:black">Conclusions:</span></strong><br /> <span style="color:black">Transcatheter E2E mitral repair led to reduction of MR severity and improvement in functional capacity. Residual MR is associated to adverse outcomes and independently linked to higher heart failure hospitalization, mortality, and poorer functional recovery. Optimizing MR reduction through careful patient selection and procedural refinement is essential to maximize long-term survival and quality-of-life benefits.</span></span></span></span></p>
Slides
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