Transcatheter edge-to-edge repair (TEER) has become established therapy for mitral regurgitation (MR) in appropriately selected patients, supported by a strong recent evidence base. The RESHAPE-HF2 trial showed that in patients with moderate-to-severe functional MR who remained symptomatic on guideline-directed medical therapy, TEER reduced heart-failure hospitalization and cardiovascular death and improved health status. The MATTERHORN trial found TEER non-inferior to surgery for secondary MR in higher-risk patients, with far fewer 30-day major adverse events. And five-year data from COAPT confirmed durable reductions in heart-failure hospitalization and mortality with TEER on top of medical therapy.
Together these establish TEER as a cornerstone for secondary/functional MR that persists despite optimized medical therapy, while surgery remains important for primary (degenerative) MR in suitable candidates. Dedicated transcatheter mitral valve replacement devices are in development for anatomy unsuitable for repair.
Further reading: RESHAPE-HF2 (Anker et al., NEJM 2024); MATTERHORN (Baldus et al., NEJM 2024); COAPT five-year follow-up (Stone et al., NEJM 2023).