Mitral Transcatheter Edge to Edge Repair in Primary Mitral Regurgitation Cardiogenic Shock.

Document Type

Conference Proceeding

Publication Date

4-2026

Publication Title

Journal of the American College of Cardiology

Abstract

Background: Cardiogenic shock secondary to severe mitral regurgitation (MR) has high mortality despite current medical treatment and interventional devices. Transcatheter edge to edge repair (TEER) may be an option in this patient population.

Case: A 74-year-old female with a history of myxomatous mitral valve disease presented with acute heart failure secondary to severe MR confirmed on transesophageal echocardiogram (TEE). Left and right heart catheterization were performed demonstrating normal coronary arteries and elevated biventricular filling pressures with large V-waves. Consequently, an intra-aortic balloon pump (IABP) was placed. Despite aggressive measures, patient remained hemodynamically unstable ultimately requiring mitral (TEER) with marked improvement of her condition.

Decision-Making: Per EVEREST-II and COAPT trials, mitral TEER has emerged as a therapy for high-risk patients with MR and is classified as 2a on current guidelines. Despite this, implementation in cases of cardiogenic shock with severe MR is unclear with observational series suggesting reduction in heart failure hospitalization and mortality. CAPITAL MINOS is seeking to answer this question comparing mitral TEER to medical therapy in this patient population.

Conclusion: Successful TEER could be a viable option for patients who develop cardiogenic shock from severe mitral regurgitation despite aggressive management and for high-risk patients who are not candidates for surgical mitral valve repair.

Volume

87

Issue

13 Suppl

First Page

A1914

Comments

American College of Cardiology 75th Annual Scientific Session & Expo, March 28-30, 2026, New Orleans, LA

Last Page

A1914

DOI

doi:10.1016/j.jacc.2026.02.4768

ISSN

0735-1097

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