Background: Mitral regurgitation (MR) is a globally endemic heart disease burden with significant morbidity and mortality. Mitral transcatheter edge-to-edge repair (M-TEER) has emerged as a minimally invasive treatment with established safety and intermediate-term efficacy.
Objectives: This study aimed to determine M-TEER durability, and incidence, risk factors and treatment strategies of M-TEER failure.
Methods: A comprehensive literature review was performed, identifying 457 records of which 3 full-text articles were included. Definitions of MR recurrence, reintervention and M-TEER durability/failure were provided. Based on these definitions, weighted means with 95% confidence intervals were calculated for the rates of MR recurrence, reintervention and their composite, for both the overall population and the primary/secondary MR subgroups.
Results: The pooled weighted means of MR recurrence and reintervention ranged between 5% and 10% in the first months after the index procedure, remained relatively stable for the first 3 years, and increased at 5 years to 17% and 9%, respectively. MR recurrence and reintervention weighted means were numerically higher in primary than secondary MR and 41% of the primary MR patients experienced MR recurrence or reintervention at 5 years. Redo TEER for M-TEER failure seemed safer than surgery but was associated with 1-year MR recurrence rates between 20% and 40%. Mitral valve replacement was the most common surgical technique for M-TEER failure.
Conclusions: The incidence of M-TEER failure after a successful index procedure increases after 3 years and is more pronounced with primary than secondary MR. More systematic longer-term follow-up data after M-TEER is required to better define M-TEER durability.
Editors
Editor-in-Chief
Harlan M. Krumholz, MD, SM, FACC
CME Editor
Ragavendra R. Baliga, MD
Author
Nicolas M Van Mieghem, MD PhD
Important Dates
Date of Release: May 11, 2026
Term of Approval/Date of CME/MOC Expiration: May 10, 2027