{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:31:01Z","timestamp":1776173461772,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T00:00:00Z","timestamp":1755993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T00:00:00Z","timestamp":1755993600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal management of secondary mitral regurgitation (MR) remains uncertain, with surgical and percutaneous approaches offering alternative treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare percutaneous repair with mitral transcatheter edge\u2010to\u2010edge repair (M\u2010TEER) using MitraClip and surgical intervention in patients with secondary MR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, and Cochrane for studies comparing M\u2010TEER using MitraClip with surgery in secondary MR, reporting outcomes of interest. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random\u2010effects model in R software. Heterogeneity was assessed with I\u00b2 statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 11 studies (two randomized controlled trials and nine observational studies) comprising 1605 patients were included. The mean age was 69 years. Among them, 906 (57.7%) underwent MitraClip. Mean follow\u2010up was 24.7 months (minimum: 6 months). The rate of MR grade\u2009\u2264\u20092+ at follow\u2010up was lower in the MitraClip group compared to surgery (RR: 0.86, 95% CI: 0.78 to 0.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). No significant differences were observed in all\u2010cause mortality (RR: 1.18, 95% CI: 0.93 to 1.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.16), cardiovascular mortality (RR: 1.42, 95% CI: 0.54 to 3.68,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.47), heart failure hospitalizations (RR: 1.55, 95% CI: 0.79 to 3.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.20), or NYHA class I\/II at follow\u2010up (RR: 0.92, 95% CI: 0.83 to 1.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although patients undergoing MitraClip exhibited a lower rate of residual MR\u2009\u2264\u20092+ at follow\u2010up compared to those treated surgically, this did not translate into higher rates of clinical outcomes, including all\u2010cause mortality, cardiovascular mortality, heart failure hospitalizations, or impaired functional status (NYHA classification).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70114","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T05:41:18Z","timestamp":1756100478000},"page":"2675-2685","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["MitraClip Versus Surgery for Secondary Mitral Regurgitation: A Systematic Review and Updated Meta\u2010Analysis"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7606-752X","authenticated-orcid":false,"given":"Juan","family":"Pinilla","sequence":"first","affiliation":[{"name":"CES University, School of Medicine Medell\u00edn Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4601-3416","authenticated-orcid":false,"given":"Sebastian","family":"Jaramillo","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias Biom\u00e9dicas Universidad Austral Pilar Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1484-4581","authenticated-orcid":false,"given":"Mariano","family":"Gallo Ruelas","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Nutricional Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1833-5346","authenticated-orcid":false,"given":"Miguel","family":"Samaniego","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma Metropolitana Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9484-4038","authenticated-orcid":false,"given":"Brijesh","family":"Baral","sequence":"additional","affiliation":[{"name":"Birat Medical College and Teaching Hospital Biratnagar Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7751-6848","authenticated-orcid":false,"given":"Nyree","family":"Nava","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma Metropolitana Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6544-8450","authenticated-orcid":false,"given":"Ivo","family":"Queiroz","sequence":"additional","affiliation":[{"name":"Department of Medicine Catholic University of Pernambuco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7814-2749","authenticated-orcid":false,"given":"Fabio","family":"R. Farias","sequence":"additional","affiliation":[{"name":"Federal University of Parana Curitiba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8960-7006","authenticated-orcid":false,"given":"Philippe","family":"Garot","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud (ICPS), H\u00f4pital Jacques Cartier Ramsay\u2010Sant\u00e9 Massy France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2024.06.018"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab395"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2314328"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2300213"},{"key":"e_1_2_11_6_1","first-page":"e72","article-title":"2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto C. 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