Echocardiographic Assessment of Residual Mitral Regurgitation to Predict Outcomes Following Mitral Trans-Catheter Edge-to-Edge Repair: Intra-Procedure TEE Versus Post-Procedure TTE

Authors

• Ivan Hanson, Corewell Health East
• Amr Abbas, Corewell Health East
• Brian Renard, Corewell Health East
• Ahmad Jabri, Corewell Health East
• William Merhi, Corewell Health West
• Gorav Ailawadi
• Raed Alnajjar
• Jeremy Albright
• Stanley Chetcuti

Document Type

Conference Proceeding

Publication Date

6-2026

Publication Title

Structural Heart

Abstract

Background: The relative ability of intra-procedural TEE versus post-procedure TTE to predict clinical outcome after mitral TEER has not been established. Methods: We performed a retrospective cohort study of patients undergoing mitral TEER utilizing data from the Michigan Structural Heart Consortium (MISHC), a statewide multicenter collaborative registry. A McNemar test was performed to assess agreement in MR grade between the two echo modalities. Numeric variables were summarized by means and standard deviations; categorical variables were summarized by counts and frequencies. Unadjusted differences across levels of MR were tested with one-way ANOVA (numeric) and chi-square or Fisher exact tests (categorical). Results: The study cohort comprised 2310 patients treated between January 1, 2016, to December 21, 2024. Patients were majority male (54.6%) with a median age of 77.4 years, and 80.5% of patients were in New York Heart Association (NYHA) class III/IV. At baseline, 87.3% patients had ≥moderate-severe MR. By intraprocedural TEE, 395 (17.1%) had trace MR, 1351 (58.5%) had mild MR and 564 (24.4%) had ≥ moderate MR post TEER. By postprocedural TTE, 474 (20.5%) had trace MR, 1302 (56.4%) had mild MR and 534 (23.2%) had ≥ moderate MR post TEER. There was discordance in MR grading in 893 (38.7%) of patients (p=0.003). Effect of MR grade on various adverse outcomes, as assessed by either intraprocedural TEE or post-procedural TTE, is summarized in the table. Conclusion: Despite discordance in grading of residual MR following mitral TEER as assessed by intraprocedural TEE versus post-procedural TTE, the presence of residual ≥ moderate MR as assessed by either modality predicted increased mortality at 1 year, increased NYHA class at 30 days and 1 year, increased heart failure readmissions at 30 days and 1 year, and decrease in KCCQ score at 30 days and 1 year.

Volume

10

Issue

6 Suppl

First Page

100940

Comments

New York Valves The Structural Heart Summit, June 24-26, 2026, New York, NY

Last Page

100940

Recommended Citation

Hanson I, Abbas A, Renard B, Jabri A, Merhi W, Ailawadi G, et al. Echocardiographic assessment of residual mitral regurgitation to predict outcomes following mitral trans-catheter edge-to-edge repair: intra-procedure TEE versus post-procedure TTE. Struct Heart. 2026 Jun;10(6 Suppl):100940. doi:10.1016/j.shj.2026.100940

DOI

10.1016/j.shj.2026.100940