Overview

• TEER was associated with a 35% lower risk of the composite endpoint of all-cause mortality and heart failure hospitalization compared to medical therapy alone in elderly patients with atrial functional mitral regurgitation.
• All-cause mortality was 42% lower in the TEER group than in those receiving medical therapy, with three-year combined death or hospitalization incidence estimated at 21.0% versus 44.3%.
• Patients who achieved mild or less residual mitral regurgitation at discharge had more than a 50% reduction in death or hospitalization, whereas moderate or greater residual regurgitation offered no clear benefit over medical treatment.
• The study analyzed 1,081 patients from the OCEAN-Mitral and REVEAL-AFMR registries using propensity score–based overlap weighting to compare 441 TEER cases with 640 medically managed controls.
• Despite over 78% procedural success and a 2.9% complication rate, the observational design limits causal inference and leaves room for unmeasured confounding.