Transcatheter Edge-to-Edge Mitral Valve Repair versus Minimally Invasive Mitral Valve Surgery: An Observational Study

Miriam Silaschi, Franca Cattelaens, Hossien Alirezaei, Johanna Vogelhuber, Susanne Sommer, Atsushi Sugiura, Max Schulz, Tetsu Tanaka, Mitsumasa Sudo, Sebastian Zimmer, Georg Nickenig, Marcel Weber, Farhad Bakhtiary, Nihal Wilde

Research output: Contribution to journalArticlepeer-review


Background: Minimally invasive mitral valve surgery (MIC-MVS) has been established as preferred treatment of mitral regurgitation (MR), but mitral transcatheter edge-to-edge valve repair (M-TEER) is routinely performed in patients at high surgical risk and is increasingly performed in intermediate risk patients. Methods: From 2010 to 2021, we performed 723 M-TEER and 123 isolated MIC-MVS procedures. We applied a sensitivity analysis by matching age, left ventricular ejection fraction (LVEF), EuroSCORE II and etiology of MR. Results: Baseline characteristics showed significant differences in the overall cohort (p < 0.01): age 78.3 years vs. 61.5 years, EuroSCORE II 5.5% vs. 1.3% and LVEF 48.4% vs. 60.4% in M-TEER vs. MIC-MVS patients. Grade of MR at discharge was moderate/severe in 24.5% (171/697) in M-TEER vs. 6.5% (8/123) in MIC-MVS (p < 0.01). One-year survival was 91.5% (552/723) in M-TEER vs. 97.6% (95/123) in MIC-MVS (p = 0.04). A matching with 49 pairs (n = 98) showed comparable survival during follow-up, but a numerically higher mean mitral valve gradient of 4.1 mmHg (95% CI: 3.6–4.6) vs. 3.4 mmHg (95% CI: 3.0–3.8) in M-TEER (p = 0.04). Conclusions: Patients undergoing M-TEER had lower one-year survival than MIC-MVS, but differences disappeared after matching. Reduction in MR was less effective in M-TEER patients and postprocedural mitral valve gradients were higher.

Original languageEnglish
Article number1372
JournalJournal of Clinical Medicine
Issue number5
Publication statusPublished - Mar 2024
Externally publishedYes


  • edge-to-edge repair
  • innovations
  • microinvasive cardiac surgery
  • minimally invasive cardiac surgery
  • mitral regurgitation
  • mitral valve surgery


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