{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T18:10:59Z","timestamp":1760551859207,"version":"3.41.2"},"reference-count":43,"publisher":"IMR Press","issue":"1","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background: Transcatheter edge-to-edge repair of mitral valve (M-TEER) is reasonable consideration in symptomatic patients with severe degenerative mitral regurgitation (MR) who are at high or prohibitive risk of surgical repair or replacement. In symptomatic patients on maximally tolerated medical therapy with severe secondary MR from left ventricular systolic dysfunction, M-TEER is reasonable therapeutic option. Methods: In this review, we present a comprehensive overview of the most recent literature and considerations for M-TEER in patients excluded from key trials. These include patients with cardiogenic shock, acute ischemic MR, atrial functional MR, failed surgical mitral valve prosthesis and pulmonary hypertension. Conclusions: M-TEER is feasible and a reasonable alternative option for these patient populations with a significant clinical benefit. However, randomized clinical trials are needed to ascertain findings from these observational studies.<\/jats:p>","DOI":"10.31083\/j.rcm2401015","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T08:26:04Z","timestamp":1673252764000},"source":"Crossref","is-referenced-by-count":1,"title":["Transcatheter Edge-to-Edge Repair of Mitral Valve Regurgitation: Closing the Gap to Broaden the Coverage"],"prefix":"10.31083","volume":"24","author":[{"given":"Hafiz","family":"Imran","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, RI 02903, USA"},{"name":"Lifespan Cardiovascular Institute, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khansa","family":"Ahmad","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, RI 02903, USA"},{"name":"Lifespan Cardiovascular Institute, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Baig","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, RI 02903, USA"},{"name":"Lifespan Cardiovascular Institute, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Islam Y.","family":"Elgendy","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY 40536, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasir","family":"Iqbal","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Azra Naheed Medical College, 55150 Lahore, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afshin","family":"Ehsan","sequence":"first","affiliation":[{"name":"Lifespan Cardiovascular Institute, Providence, RI 02903, USA"},{"name":"Division of Cardiothoracic Surgery, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry","family":"Sharaf","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, RI 02903, USA"},{"name":"Lifespan Cardiovascular Institute, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Gordon","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, RI 02903, USA"},{"name":"Lifespan Cardiovascular Institute, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan","family":"Saad","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, RI 02903, USA"},{"name":"Lifespan Cardiovascular Institute, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Goel SS, Bajaj N, Aggarwal B, Gupta S, Poddar KL, Ige M, et al. 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Transcatheter mitral valve repair for inotrope dependent cardiogenic shock \u2013 Design and rationale of the CAPITAL MINOS trial. American Heart Journal. 2022; 254: 81\u201387.","DOI":"10.1016\/j.ahj.2022.08.008"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Lopez-Perez M, Estevez-Loureiro R, Lopez-Sainz A, Couto-Mallon D, Soler-Martin MR, Bouzas-Mosquera A, et al. Long-term prognostic value of mitral regurgitation in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention. American Journal of Cardiology. 2014; 113: 907\u2013912.","DOI":"10.1016\/j.amjcard.2013.11.050"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Mentias A, Raza MQ, Barakat AF, Hill E, Youssef D, Krishnaswamy A, et al. Prognostic Significance of Ischemic Mitral Regurgitation on Outcomes in Acute ST-Elevation Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention. The American Journal of Cardiology. 2017; 119: 20\u201326.","DOI":"10.1016\/j.amjcard.2016.09.007"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Kardiologia Polska. 2018; 76: 22\u2013313. (In Polish)","DOI":"10.5603\/KP.2018.0041"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Alajaji WA, Akl EA, Farha A, Jaber WA, AlJaroudi WA. Surgical versus medical management of patients with acute ischemic mitral regurgitation: a systematic review. BMC Research Notes. 2015; 8: 712.","DOI":"10.1186\/s13104-015-1704-9"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Haberman D, Taramasso M, Czarnecki A, Kerner A, Chrissoheris M, Spargias K, et al. Salvage MitraClip in severe secondary mitral regurgitation complicating acute myocardial infarction: data from a multicentre international study. European Journal of Heart Failure. 2019; 21: 1161\u20131164.","DOI":"10.1002\/ejhf.1565"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Estevez-Loureiro R, Adamo M, Arzamendi D, Denti P, Freixa X, Nombela-Franco L, et al. Transcatheter mitral valve repair in patients with acute myocardial infarction: insights from the European Registry of MitraClip in Acute Mitral Regurgitation following an acute myocardial infarction (EREMMI). EuroIntervention. 2020; 15: 1248\u20131250.","DOI":"10.4244\/EIJ-D-19-00653"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Haberman D, Estevez-Loureiro R, Benito-Gonzalez T, Denti P, Arzamendi D, Adamo M, et al. Conservative, surgical, and percutaneous treatment for mitral regurgitation shortly after acute myocardial infarction. European Heart Journal. 2022; 43: 641\u2013650.","DOI":"10.1093\/eurheartj\/ehab496"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Sodhi N, Asch FM, Ruf T, Petrescu A, von Bardeleben S, Lim DS, et al. Clinical Outcomes With Transcatheter Edge-to-Edge Repair in Atrial Functional MR From the EXPAND Study. JACC: Cardiovascular Interventions. 2022; 15: 1723\u20131730.","DOI":"10.1016\/j.jcin.2022.07.023"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Yoon SH, Makar M, Kar S, Chakravarty T, Oakley L, Sekhon N, et al. Outcomes After Transcatheter Edge-to-Edge Mitral Valve Repair According to Mitral Regurgitation Etiology and Cardiac Remodeling. JACC: Cardiovascular Interventions. 2022; 15: 1711\u20131722.","DOI":"10.1016\/j.jcin.2022.07.004"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Tanaka T, Sugiura A, \u00d6zt\u00fcrk C, Vogelhuber J, Tabata N, Wilde N, et al. Transcatheter Edge-to-Edge Repair for Atrial Secondary Mitral Regurgitation. 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American Journal of Cardiology. 2021; 161: 70\u201375.","DOI":"10.1016\/j.amjcard.2021.08.062"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Benito-Gonz\u00e1lez T, Carrasco-Chinchilla F, Est\u00e9vez-Loureiro R, Pascual I, Arzamendi D, Garrote-Coloma C, et al. Clinical and echocardiographic outcomes of transcatheter mitral valve repair in atrial functional mitral regurgitation. International Journal of Cardiology. 2021; 345: 29\u201335.","DOI":"10.1016\/j.ijcard.2021.09.056"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Rahhab Z, Lim DS, Little SH, Taramasso M, Kuwata S, Saccocci M, et al. MitraClip After Failed Surgical Mitral Valve Repair-An International Multicenter Study. Journal of the American Heart Association. 2021; 10: e019236.","DOI":"10.1161\/JAHA.120.019236"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Singh GD, Smith TW, Boyd WD, Rogers JH. Clipping the Ring: Transcatheter Edge-to-Ring Mitral Valve Repair in a Patient With Prior Mitral Annuloplasty Ring. JACC: Cardiovascular Interventions. 2018; 11: e55\u2013e58.","DOI":"10.1016\/j.jcin.2017.10.037"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Kainuma S, Taniguchi K, Toda K, Funatsu T, Kondoh H, Nishino M, et al. Pulmonary hypertension predicts adverse cardiac events after restrictive mitral annuloplasty for severe functional mitral regurgitation. The Journal of Thoracic and Cardiovascular Surgery. 2011; 142: 783\u2013792.","DOI":"10.1016\/j.jtcvs.2010.11.031"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Matsumoto T, Nakamura M, Yeow WL, Hussaini A, Ram V, Makar M, et al. Impact of pulmonary hypertension on outcomes in patients with functional mitral regurgitation undergoing percutaneous edge-to-edge repair. American Journal of Cardiology. 2014; 114: 1735\u20131739.","DOI":"10.1016\/j.amjcard.2014.08.044"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Tigges E, Blankenberg S, von Bardeleben RS, Zurn C, Bekeredjian R, Ouarrak T, et al. Implication of pulmonary hypertension in patients undergoing MitraClip therapy: results from the German transcatheter mitral valve interventions (TRAMI) registry. European Journal of Heart Failure. 2018; 20: 585\u2013594.","DOI":"10.1002\/ejhf.864"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Al-Bawardy R, Vemulapalli S, Thourani VH, Mack M, Dai D, Stebbins A, et al. Association of Pulmonary Hypertension With Clinical Outcomes of Transcatheter Mitral Valve Repair. JAMA Cardiology. 2020; 5: 47\u201356.","DOI":"10.1001\/jamacardio.2019.4428"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Kottenberg E, Dumont M, Frey UH, Heine T, Plicht B, Kahlert P, et al. The minimally invasive MitraClip procedure for mitral regurgitation under general anaesthesia: immediate effects on the pulmonary circulation and right ventricular function. Anaesthesia. 2014; 69: 860\u2013867.","DOI":"10.1111\/anae.12712"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Mandurino\u2010Mirizzi A, Crimi G, Raineri C, Magrini G, Gazzoli F, Frassica R, et al. Haemodynamic impact of MitraClip in patients with functional mitral regurgitation and pulmonary hypertension. European Journal of Clinical Investigation. 2021; 51: e13676.","DOI":"10.1111\/eci.13676"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Mandurino-Mirizzi A, Munafo A, Raineri C, Magrini G, Frassica R, Arzuffi L, et al. Response to acute vasodilator challenge and haemodynamic modifications after MitraClip in patients with functional mitral regurgitation and pulmonary hypertension. European Heart Journal: Acute Cardiovascular Care. 2022; 11: 464\u2013469.","DOI":"10.1093\/ehjacc\/zuac053"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Neuss M, Schau T, Isotani A, Pilz M, Schopp M, Butter C. Elevated Mitral Valve Pressure Gradient After MitraClip Implantation Deteriorates Long-Term Outcome in Patients With Severe Mitral Regurgitation and Severe Heart Failure. JACC: Cardiovascular Interventions. 2017; 10: 931\u2013939.","DOI":"10.1016\/j.jcin.2016.12.280"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Patzelt J, Zhang W, Sauter R, Mezger M, Nording H, Ulrich M, et al. Elevated Mitral Valve Pressure Gradient Is Predictive of Long-Term Outcome After Percutaneous Edge-to-Edge Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation ( MR ), But Not in Functional MR. Journal of the American Heart Association. 2019; 8: e011366.","DOI":"10.1161\/JAHA.118.011366"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Rubino AS, Onorati F, Santarpia G, Achille F, Lorusso R, Santini F, et al. Impact of increased transmitral gradients after undersized annuloplasty for chronic ischemic mitral regurgitation. International Journal of Cardiology. 2012; 158: 71\u201377.","DOI":"10.1016\/j.ijcard.2011.01.006"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Halaby R, Herrmann HC, Gertz ZM, Lim S, Kar S, Lindenfeld J, et al. Effect of Mitral Valve Gradient After MitraClip on Outcomes in Secondary Mitral Regurgitation: Results From the COAPT Trial. JACC: Cardiovascular Interventions. 2021; 14: 879\u2013889.","DOI":"10.1016\/j.jcin.2021.01.049"},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Yoon SH, Makar M, Kar S, Chakravarty T, Oakley L, Sekhon N, et al. Prognostic Value of Increased Mitral Valve Gradient After Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation. 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