{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:29:55Z","timestamp":1792193395501,"version":"4.4.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Transcatheter edge\u2010to\u2010edge repair of the mitral valve (M\u2010TEER) has demonstrated promising outcomes for patients with mitral regurgitation who are unsuitable for surgical intervention. However, the clinical implications of M\u2010TEER in patients requiring mechanical circulatory support (MCS) for unstable hemodynamics remains unclear. This study aimed to evaluate the outcomes of MCS\u2010assisted M\u2010TEER in critically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Consecutive patients who underwent M\u2010TEER for significant mitral regurgitation were identified from the Japanese multicenter OCEAN\u2010Mitral (Optimized Catheter Valvular Intervention\u2013Mitral) registry. All\u2010cause death was compared between the cohort undergoing MCS\u2010assisted M\u2010TEER and a virtual control group receiving MCS alone without undergoing M\u2010TEER, estimated using the Seattle Heart Failure Model. Additionally, logistic regression analysis was conducted to identify factors associated with in\u2010hospital death following MCS\u2010assisted M\u2010TEER.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 3764 patients were included in the analysis (mean age, 81\u2009years; 54.9% men; 70.1% with secondary mitral regurgitation), of whom 105 underwent MCS\u2010assisted M\u2010TEER. Procedure success exceeded 95%, irrespective of MCS use. The 1\u2010year mortality rate in the MCS\u2010assisted M\u2010TEER group was lower than the estimated mortality rate in the virtual control group (43.2% versus 69.5%). Factors associated with in\u2010hospital death included frailty, inflammation, and hypoalbuminemia. In a landmark analysis starting from discharge date, there was no statistically significant difference in cardiovascular death or heart failure hospitalization between the groups with or without the use of MCS (hazard ratio, 1.45 [95% CI, 0.93\u20132.26];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.10).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">MCS\u2010assisted M\u2010TEER appears to be a viable and effective therapeutic strategy for carefully selected patients with significant mitral regurgitation and unstable hemodynamics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.umin.ac.jp\/ctr\/\">https:\/\/www.umin.ac.jp\/ctr\/<\/jats:ext-link>\n                      ; Unique identifier: UMIN\u2010ID: UMIN000023653\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.042785","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T10:49:14Z","timestamp":1765363754000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Safety and Prognostic Implications of Mechanical Circulatory Support\u2010Assisted Transcatheter Edge\u2010to\u2010Edge Repair: The OCEAN\u2010Mitral Registry"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7551-3431","authenticated-orcid":false,"given":"Shuhei","family":"Tanaka","sequence":"first","affiliation":[{"name":"University of 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