TY - JOUR
T1 - TRANScatheter edge-to-edge rePAir for SAM related mitral REgurgitation in patieNTs with HCM. The TRANSPARENT registry
AU - Testa, Luca
AU - Arzuffi, Luca
AU - Rubbio, Antonio Popolo
AU - Brambilla, Nedy
AU - Maisano, Francesco
AU - Agricola, Eustachio
AU - Shuvy, Mony
AU - Mangieri, Antonio
AU - Grasso, Carmelo
AU - Latib, Azeem
AU - De Backer, Ole
AU - Amat Santos, Ignacio J
AU - Tarantini, Giuseppe
AU - Castriota, Fausto
AU - Benito-González, Tomás
AU - Biasco, Luigi
AU - Estévez-Loureiro, Rodrigo
AU - Perl, Leor
AU - Tusa, Maurizio B
AU - Bedogni, Francesco
N1 - Copyright © 2025. Published by Elsevier Inc.
PY - 2026/3/9
Y1 - 2026/3/9
N2 - BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by left ventricular hypertrophy, left ventricle outflow tract obstruction (LVOTO), systolic anterior motion (SAM), and subsequent mitral regurgitation (MR). Although its risk/benefit profile remains unclear, transcatheter mitral edge-to-edge repair (M-TEER) may be beneficial for patients at high or prohibitive surgical risk.OBJECTIVES: Evaluate the safety and efficacy of M-TEER in patients with obstructive HCM and moderate-to-severe or severe SAM-related MR.METHODS: Retrospective, international, multicenter study including 35 symptomatic patients treated with M-TEER at 12 centers. MVARC definitions were applied. Echocardiographic and clinical outcomes were assessed at discharge, 30 days, 1 year, and last available follow-up.RESULTS: MVARC technical, 30-day device and procedural success were achieved in 94%, 91% and 88% of the cases, respectively. MR <2 was achieved in 97% of patients. LVOT gradient decreased from 62.0 mmHg (IQR 35.5-92.0) to 16.0 mmHg (IQR 12.0-22.0), p<0.05, and the reduction persisted at a median follow-up of 523 days. NYHA class I/II increased from 31% to 88% at last follow-up. The composite outcome (all-cause death, admission for acute decompensated heart failure, M-TEER re-do, surgical mitral valve replacement) occurred in 26% of the cases, mainly driven by ADHF.CONCLUSIONS: M-TEER appears to be a feasible and safe therapeutic option for anatomically suitable patients with obstructive HCM, LVOTO and SAM-related MR who are at high or prohibitive surgical risk. Larger scale data are warranted to further elucidate the role of M-TEER in this subset of patients.
AB - BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by left ventricular hypertrophy, left ventricle outflow tract obstruction (LVOTO), systolic anterior motion (SAM), and subsequent mitral regurgitation (MR). Although its risk/benefit profile remains unclear, transcatheter mitral edge-to-edge repair (M-TEER) may be beneficial for patients at high or prohibitive surgical risk.OBJECTIVES: Evaluate the safety and efficacy of M-TEER in patients with obstructive HCM and moderate-to-severe or severe SAM-related MR.METHODS: Retrospective, international, multicenter study including 35 symptomatic patients treated with M-TEER at 12 centers. MVARC definitions were applied. Echocardiographic and clinical outcomes were assessed at discharge, 30 days, 1 year, and last available follow-up.RESULTS: MVARC technical, 30-day device and procedural success were achieved in 94%, 91% and 88% of the cases, respectively. MR <2 was achieved in 97% of patients. LVOT gradient decreased from 62.0 mmHg (IQR 35.5-92.0) to 16.0 mmHg (IQR 12.0-22.0), p<0.05, and the reduction persisted at a median follow-up of 523 days. NYHA class I/II increased from 31% to 88% at last follow-up. The composite outcome (all-cause death, admission for acute decompensated heart failure, M-TEER re-do, surgical mitral valve replacement) occurred in 26% of the cases, mainly driven by ADHF.CONCLUSIONS: M-TEER appears to be a feasible and safe therapeutic option for anatomically suitable patients with obstructive HCM, LVOTO and SAM-related MR who are at high or prohibitive surgical risk. Larger scale data are warranted to further elucidate the role of M-TEER in this subset of patients.
KW - HCM
KW - M-TEER
KW - mitral regurgitation
KW - systolic anterior motion
UR - https://www.scopus.com/pages/publications/105031289648
U2 - 10.1016/j.jcin.2025.10.013
DO - 10.1016/j.jcin.2025.10.013
M3 - Journal article
C2 - 41146483
SN - 1936-8798
VL - 19
SP - 604
EP - 614
JO - JACC. Cardiovascular interventions
JF - JACC. Cardiovascular interventions
IS - 5
ER -