Universität zu Köln

von Stein, Philipp ORCID: 0000-0003-4548-3897, Stolz, Lukas ORCID: 0000-0002-1362-1493, Haurand, Jean Marc ORCID: 0000-0001-8606-3595, Gröger, Matthias ORCID: 0000-0003-4082-3901, Rudolph, Felix ORCID: 0000-0003-4948-6438, Mustafa, Donika, Jobst, Jannik, Mues, Christoph Alexander, Mahabadi, Amir Abbas ORCID: 0000-0003-2336-7991, Hoerbrand, Isabel A., Schulz, Carl, Sugiura, Atsushi, von Stein, Jennifer ORCID: 0009-0000-3871-164X, Iliadis, Christos ORCID: 0000-0001-7655-8500, Lurz, Philipp, Gerçek, Muhammed, Horn, Patrick, Kessler, Mirjam, Ascione, Guido ORCID: 0000-0002-7727-0573, Rassaf, Tienush, Weber, Marcel ORCID: 0000-0003-4100-9522, Schofer, Niklas, Konstandin, Mathias, Schindhelm, Florian, Möllmann, Helge, Unsöld, Bernhard, Guthoff, Henning ORCID: 0000-0002-0979-1190, Baldus, Stephan ORCID: 0000-0001-8259-1737, Rottbauer, Wolfgang, Rudolph, Volker ORCID: 0000-0001-5385-6839, Granada, Juan F., Hausleiter, Jörg, Pfister, Roman ORCID: 0000-0002-4358-5008, Mauri, Victor, von Bardeleben, Ralph-Stephan, Ennin, Cecilia, Friedrichs, Kai Peter, Grothusen, Christina, Kelm, Malte, Kister, Tobias, Nickenig, Georg, Piayda, Kerstin, Ruf, Tobias, Sagmeister, Paula, Schneider, Leonhard Moritz, Thiele, Holger and Widmann, Laila (2025). Transcatheter Edge-to-Edge Repair for Atrial and Ventricular Secondary Mitral Regurgitation. JACC: Cardiovascular Interventions, 18 (16). pp. 2020-2032. JACC: Cardiovascular Interventions. ISSN 1936-8798

PDF von-stein-et-al-2025-transcatheter-edge-to-edge-repair-for-atrial-and-ventricular-secondary-mitral-regurgitation.pdf Bereitstellung unter der CC-Lizenz: Creative Commons Attribution Non-commercial No Derivatives. Download (3MB)

Abstract

BACKGROUND: Secondary mitral regurgitation (SMR) has 2 phenotypes: atrial (aSMR) and ventricular (vSMR). The role of mitral valve transcatheter edge-to-edge repair (M-TEER) in aSMR remains less defined, with limited evidence on the PASCAL implant (Edwards Lifesciences). OBJECTIVES: The authors sought to evaluate and compare outcomes of SMR phenotypes undergoing M-TEER. METHODS REPAIR (REgistry of PAscal for mItral Regurgitation) is an investigator-initiated, multicenter registry of patients undergoing M-TEER. aSMR was defined by left atrial dilation with preserved left ventricular size and ejection fraction. Outcomes included MR #1+ at discharge, technical success, NYHA functional class improvement, and 1-year survival. RESULTS: Among 915 patients (166 [18%] aSMR, 749 [82%] vSMR), the median follow-up was 491 days (Q1-Q3: 360- 833 days). MR #1+ was achieved in 77.2% vs 71.4% (P = 0.162), with technical success in 97.0% vs 98.3% (P = 0.446). NYHA functional class improved in both phenotypes (P < 0.001), with 61.2% vs 61.3% in functional class #II at follow- up (P > 0.999). One-year survival was 88.4% (95% CI: 82.8%-94.4%) vs 86.0% (95% CI: 83.1%-89.0%; P = 0.346). In aSMR patients, 1-year survival was significantly lower in patients with baseline tricuspid regurgitation (TR) grade $moderate compared with those with <moderate TR (84.3% [95% CI: 77.0%-92.3%] vs 100.0% [95% CI: 100.0%-100.0%]; P = 0.041). In vSMR patients, survival was similar between $moderate and <moderate baseline TR (83.9% [95% CI: 79.8%-88.2%] vs 89.3% [95% CI: 85.0%-93.8%]; P = 0.051). CONCLUSIONS: M-TEER effectively reduces MR to #1+ and improves symptoms in both aSMR and vSMR. Particularly in aSMR, $moderate baseline TR is linked to worse outcomes, warranting consideration as an additional treatment target.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code von Stein, Philipp UNSPECIFIED https://orcid.org/0000-0003-4548-3897 UNSPECIFIED Stolz, Lukas UNSPECIFIED https://orcid.org/0000-0002-1362-1493 UNSPECIFIED Haurand, Jean Marc UNSPECIFIED https://orcid.org/0000-0001-8606-3595 UNSPECIFIED Gröger, Matthias UNSPECIFIED https://orcid.org/0000-0003-4082-3901 UNSPECIFIED Rudolph, Felix UNSPECIFIED https://orcid.org/0000-0003-4948-6438 UNSPECIFIED Mustafa, Donika UNSPECIFIED UNSPECIFIED UNSPECIFIED Jobst, Jannik UNSPECIFIED UNSPECIFIED UNSPECIFIED Mues, Christoph Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Mahabadi, Amir Abbas UNSPECIFIED https://orcid.org/0000-0003-2336-7991 UNSPECIFIED Hoerbrand, Isabel A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulz, Carl UNSPECIFIED UNSPECIFIED UNSPECIFIED Sugiura, Atsushi UNSPECIFIED UNSPECIFIED UNSPECIFIED von Stein, Jennifer UNSPECIFIED https://orcid.org/0009-0000-3871-164X UNSPECIFIED Iliadis, Christos UNSPECIFIED https://orcid.org/0000-0001-7655-8500 UNSPECIFIED Lurz, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerçek, Muhammed UNSPECIFIED UNSPECIFIED UNSPECIFIED Horn, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Kessler, Mirjam UNSPECIFIED UNSPECIFIED UNSPECIFIED Ascione, Guido UNSPECIFIED https://orcid.org/0000-0002-7727-0573 UNSPECIFIED Rassaf, Tienush UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Marcel UNSPECIFIED https://orcid.org/0000-0003-4100-9522 UNSPECIFIED Schofer, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Konstandin, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Schindhelm, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Möllmann, Helge UNSPECIFIED UNSPECIFIED UNSPECIFIED Unsöld, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Guthoff, Henning UNSPECIFIED https://orcid.org/0000-0002-0979-1190 UNSPECIFIED Baldus, Stephan UNSPECIFIED https://orcid.org/0000-0001-8259-1737 UNSPECIFIED Rottbauer, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Volker UNSPECIFIED https://orcid.org/0000-0001-5385-6839 UNSPECIFIED Granada, Juan F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hausleiter, Jörg UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED https://orcid.org/0000-0002-4358-5008 UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bardeleben, Ralph-Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Ennin, Cecilia UNSPECIFIED UNSPECIFIED UNSPECIFIED Friedrichs, Kai Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Grothusen, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kelm, Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Kister, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Piayda, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruf, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Sagmeister, Paula UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Leonhard Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Thiele, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Widmann, Laila UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-805514
Identification Number:	10.1016/j.jcin.2025.05.031
Journal or Publication Title:	JACC: Cardiovascular Interventions
Volume:	18
Number:	16
Page Range:	pp. 2020-2032
Number of Pages:	13
Date:	25 August 2025
Publisher:	JACC: Cardiovascular Interventions
ISSN:	1936-8798
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Innere Medizin > Klinik III für Innere Medizin - Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language mitral regurgitation ; mitral valve transcatheter edge-to-edge repair ; M-TEER ; PASCAL ; real-world ; REPAIR English
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80551