Periprocedural pulmonary hypertension dynamics provide robust risk stratification after M-TEER, identifying low-risk patients with PH normalization and high-risk subsets with residual or new-onset PH, requiring closer surveillance and procedural optimization.
Periprocedural PH patterns after M-TEER were distributed across four groups, with most patients having PH either before or after the procedure.
The 2-year incidence of cardiovascular death or heart failure hospitalization differed significantly across the four PH groups.
Patients whose PH normalized after M-TEER had outcomes comparable to patients who never had PH.
New-onset PH and residual PH were each independently associated with worse outcomes.
Severe tricuspid regurgitation, high baseline TRPG, and tricuspid annular dilation predicted residual PH.
Residual mitral regurgitation and elevated postprocedural transmitral gradient predicted new-onset PH.
The study used a prospective multicenter Japanese registry of severe mitral regurgitation patients undergoing M-TEER.
This study looked at patients with severe leaky mitral valves who underwent a catheter-based repair (M-TEER) and asked whether changes in lung blood pressure (pulmonary hypertension, PH) around the time of the procedure relate to later outcomes. Using a large Japanese registry of about 3,500 patients, researchers sorted people into four groups: never had PH, PH that normalized after the procedure, PH that newly appeared after the procedure, and PH that persisted. Patients who never had PH and those whose PH normalized did similarly well, with roughly 18% experiencing cardiovascular death or heart failure hospitalization within two years. Those with new-onset or persistent PH had higher rates, about 27%, and remained at higher risk after adjusting for other factors. Persistent PH was linked to severe tricuspid valve leakage, very high baseline lung pressures, and an enlarged tricuspid valve ring. New PH was linked to leftover mitral leakage and a higher pressure gradient across the mitral valve after the procedure. This research suggests that checking lung pressure before and after M-TEER can help identify patients who may need closer follow-up and that optimizing the procedure result may matter. As an observational registry study, it shows associations rather than proving that these factors cause the outcomes.
Miyamoto J, Ohno Y, Noda S, Kamioka N, Murakami T, Ikari Y, et al.. (2026). Periprocedural Pulmonary Hypertension and Outcomes After Mitral Valve Transcatheter Edge-to-Edge Repair.. JACC. Cardiovascular interventions. https://doi.org/10.1016/j.jcin.2026.08.017