{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:51:15Z","timestamp":1791287475572,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mitral transcatheter edge\u2010to\u2010edge repair (M\u2010TEER) may modify mitral annular geometry beyond leaflet approximation, but the magnitude and temporal pattern of this effect remain incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess acute and delayed changes in anteroposterior (AP) and intercommissural (IC) mitral annular diameters after M\u2010TEER with MitraClip and to explore their association with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single\u2010center study included 151 patients undergoing M\u2010TEER between February 2019 and June 2023. Annular diameters were measured by transoesophageal echocardiography before intervention and by transthoracic echocardiography before discharge and at the latest available echocardiographic follow\u2010up. The primary analysis assessed continuous absolute changes in AP and IC diameters; an acute decrease of \u2265\u20091\u2009mm in either diameter was retained only as an exploratory categorization. The exploratory clinical endpoint was the composite of all\u2010cause death or heart\u2010failure hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median age was 78 (72\u221283) years, and 61% were male. From pre\u2010intervention to discharge, AP and IC diameters decreased by 2.2\u2009\u00b1\u20093.8 and 2.3\u2009\u00b1\u20093.7\u2009mm, respectively (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Using the exploratory acute threshold, 129 patients (85.4%) had a\u2009\u2265\u20091\u2009mm reduction; when categorized by the greatest reduction observed in either diameter, 16 (10.6%) had a 1\u2009mm reduction, 16 (10.6%) a 2\u2009mm reduction, 16 (10.6%) a 3\u2009mm reduction, and 81 (53.6%) a\u2009&gt;\u20093\u2009mm reduction. Echocardiographic follow\u2010up was available in 75 patients at a median of 4.7 months; the AP diameter remained stable, whereas the IC diameter showed a further reduction. During clinical follow\u2010up, 22 patients reached the composite endpoint; acute annular reduction was not associated with a significant difference in event\u2010free survival in exploratory analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>M\u2010TEER is associated with measurable acute changes in mitral annular dimensions, with additional delayed IC remodeling observed in a subset with follow\u2010up imaging. Because baseline and post\u2010procedural measurements were obtained with different echocardiographic modalities, the magnitude of the acute change should be interpreted cautiously. The prognostic relevance of annular remodeling remains hypothesis\u2010generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70928","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:57:10Z","timestamp":1791284230000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute and Delayed Mitral Annular Remodeling Following Transcatheter Edge\u2010to\u2010Edge Repair: An Echocardiographic Observational Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0259-0844","authenticated-orcid":false,"given":"Edoardo","family":"Zancanaro","sequence":"first","affiliation":[{"name":"Cardiovascular Imaging Unit, Cardio\u2010Thoracic\u2010Vascular Department IRCCS San Raffaele Scientific Institute Milan Italy"},{"name":"Department of Surgery, Division of Cardiac Surgery Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7088-8509","authenticated-orcid":false,"given":"Kamil","family":"Stankowski","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Unit, Cardio\u2010Thoracic\u2010Vascular Department IRCCS San Raffaele Scientific Institute Milan Italy"},{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging Centro Cardiologico Monzino IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1603-4238","authenticated-orcid":false,"given":"Michele","family":"Galasso","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Unit, Cardio\u2010Thoracic\u2010Vascular Department IRCCS San Raffaele Scientific Institute Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7972-0689","authenticated-orcid":false,"given":"Francesco","family":"Ancona","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Unit, Cardio\u2010Thoracic\u2010Vascular Department IRCCS San Raffaele Scientific Institute Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Denti","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery IRCCS San Raffaele Scientific Institute Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Ingallina","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Unit, Cardio\u2010Thoracic\u2010Vascular Department IRCCS San Raffaele Scientific Institute Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eustachio","family":"Agricola","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Unit, Cardio\u2010Thoracic\u2010Vascular Department IRCCS San Raffaele Scientific Institute Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3500-897X","authenticated-orcid":false,"given":"Tommaso Hinna","family":"Danesi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiac Surgery Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Maisano","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery IRCCS San Raffaele Scientific Institute Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of Valvular Heart Diseases: A Population\u2010Based Study","volume":"368","author":"Nkomo V. T.","year":"2006","journal-title":"Lancet"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jacc.2013.08.723","article-title":"Prevalence and Outcomes of Unoperated Patients With Severe Symptomatic Mitral Regurgitation and Heart Failure","volume":"63","author":"Goel S. S.","year":"2014","journal-title":"Journal of the American College of Cardiology"},{"issue":"20","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1001\/jama.2023.7089","article-title":"Transcatheter Mitral Valve Repair for Degenerative Mitral Regurgitation","volume":"329","author":"Makkar R. R.","year":"2023","journal-title":"Journal of the American Medical Association"},{"issue":"22","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1056\/NEJMoa2300213","article-title":"Five\u2010Year Follow\u2010Up After Transcatheter Repair of Secondary Mitral Regurgitation","volume":"388","author":"Stone G. W.","year":"2023","journal-title":"New England Journal of Medicine"},{"issue":"3","key":"e_1_2_10_6_1","first-page":"269","article-title":"Mitral Annular Dimensions and Geometry in Patients With Functional Mitral Regurgitation and Mitral Valve Prolapse","volume":"9","author":"Naoum C.","year":"2016","journal-title":"JACC: Cardiovascular Imaging"},{"issue":"8","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1093\/ehjci\/jev301","article-title":"Relationship Between Mitral Annulus Function and Mitral Regurgitation Severity and Left Atrial Remodelling in Patients With Primary Mitral Regurgitation","volume":"17","author":"Mihaila S.","year":"2016","journal-title":"European Heart Journal\u2013Cardiovascular Imaging"},{"issue":"3","key":"e_1_2_10_8_1","first-page":"390","article-title":"Acute Changes of Mitral Valve Geometry During Interventional Edge\u2010to\u2010Edge Repair With the MitraClip System Are Associated With Midterm Outcomes in Patients With Functional Valve Disease: Preliminary Results From a Prospective Single\u2010Center Study","volume":"7","author":"Schueler R.","year":"2014","journal-title":"Circulation: Cardiovascular Interventions"},{"issue":"9","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1093\/ehjci\/jes293","article-title":"Immediate Effect of the MitraClip(R) Procedure on Mitral Ring Geometry in Primary and Secondary Mitral Regurgitation","volume":"14","author":"Schmidt F. P.","year":"2013","journal-title":"European Heart Journal\u2013Cardiovascular Imaging"},{"issue":"23","key":"e_1_2_10_10_1","first-page":"2432","article-title":"Acute Mitral Annular Remodeling After Percutaneous Repair With MitraClip","volume":"12","author":"Melillo E.","year":"2019","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"15","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1016\/j.jacc.2011.11.081","article-title":"Surgical Approaches to Mitral Regurgitation","volume":"60","author":"Glower D. D.","year":"2012","journal-title":"Journal of the American College of Cardiology"},{"issue":"5","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"e171","DOI":"10.1093\/ehjci\/jeab253","article-title":"Multi\u2010Modality Imaging Assessment of Native Valvular Regurgitation: An EACVI and ESC Council of Valvular Heart Disease Position Paper","volume":"23","author":"Lancellotti P.","year":"2022","journal-title":"European Heart Journal\u2013Cardiovascular Imaging"},{"issue":"19","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1016\/j.jacc.2019.02.061","article-title":"Atrial Functional Mitral Regurgitation","volume":"73","author":"Deferm S.","year":"2019","journal-title":"Journal of the American College of Cardiology"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.ijcard.2016.12.081","article-title":"Impact of Interventional Edge\u2010to\u2010Edge Repair on Mitral Valve Geometry","volume":"230","author":"Schueler R.","year":"2017","journal-title":"International Journal of Cardiology"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70928","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70928","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70928","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:57:12Z","timestamp":1791284232000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":13,"alternative-id":["10.1002\/ccd.70928"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70928","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2026-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70928"}}