Durability of Mitral Valve Transcatheter Edge-to-Edge Repair: An Expert Overview (JACC Cardiovascular Interventions May 2026)-Article: Durability of Mitral Valve Transcatheter Edge-to-Edge Repair: An Expert Overview

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This expert review examined the long-term durability of mitral transcatheter edge-to-edge repair (M-TEER), a minimally invasive treatment for mitral regurgitation (MR). After screening 457 records, the authors included 33 studies and analyzed rates of MR recurrence and repeat intervention up to 5 years after a successful index procedure.<br /><br />Main findings:<br />- In the first months after M-TEER, MR recurrence and reintervention were generally low, around 5% to 10%, and stayed fairly stable through about 3 years.<br />- By 5 years, pooled rates increased to about 17% for MR recurrence and 9% for reintervention.<br />- Durability was worse in primary MR than in secondary MR. At 5 years, about 41% of patients with primary MR experienced either MR recurrence or reintervention, compared with a lower rate in secondary MR.<br />- The main early failure mechanisms differed by MR type: structural problems such as loss of leaflet insertion or single-leaflet device attachment were more common in primary MR, while functional failure due to ongoing left ventricular remodeling was more common in secondary MR and often appeared later.<br />- Newer device generations showed improved procedural success and lower early recurrence than older devices, but long-term durability still remains incompletely defined.<br /><br />Management of failed M-TEER:<br />- Redo transcatheter repair is feasible and often safer than surgery, but 1-year MR recurrence after redo procedures remains relatively high, sometimes 20% to 40%.<br />- Surgery, usually mitral valve replacement rather than repair, is effective but carries higher procedural risk, including 30-day mortality reported up to 20% in some series.<br />- Other emerging options include occluder devices, annuloplasty, and electrosurgical techniques.<br /><br />Overall, the review concludes that M-TEER durability declines meaningfully after 3 years, especially in primary MR, and that more systematic, longer-term follow-up studies are needed.

Meta Tag

Concept M-TEER

Concept Mitral Regurgitation

Concept Durability

Concept Mitral Valve Failure

Concept Structural Failure

Keywords

mitral transcatheter edge-to-edge repair

M-TEER

mitral regurgitation

durability

MR recurrence

reintervention

primary mitral regurgitation

secondary mitral regurgitation

leaflet attachment failure

redo transcatheter repair

M-TEER

Mitral Regurgitation

Durability

Mitral Valve Failure

Structural Failure