Mitral transcatheter edge-to-edge repair carries a peak periprocedural thromboembolic risk driven by device time, though near-universal subclinical ischemic lesions rarely cause overt deficits.
What are the stage-specific clinical and procedural determinants of thromboembolic risk in patients undergoing mitral transcatheter edge-to-edge repair?
This review outlines the thromboembolic continuum in M-TEER, emphasizing the periprocedural window as the peak hazard period and the need for individualized antithrombotic strategies.
Absolute Event Rate: 0% vs 0%
Mitral transcatheter edge-to-edge repair (M-TEER) has emerged as a cornerstone in the management of severe mitral regurgitation, serving as a robust, low-risk alternative to conventional mitral valve surgery. Although thromboembolic risk remains a critical clinical challenge, that varies significantly across the clinical continuum, from pre-procedural substrates to post-procedural management. This review highlights the role of atrial cardiomyopathy in creating a prothrombotic milieu even prior to intervention, while during the procedure, device time emerges as a potentially dominant independent predictor of embolic burden, marking the periprocedural window as the period of peak hazard. Furthermore, this article addresses the notable disparity between the near-universal presence of subclinical ischemic lesions on magnetic resonance imaging and the infrequent incidence of overt neurological deficits. As the post-procedural phase is considered, we discuss the shift from standardized antithrombotic protocols to individualized strategies and the potential role of concomitant left atrial appendage occlusion. Ultimately, integrating these stage-specific clinical and procedural determinants with emerging technologies—like digital twins and artificial intelligence—represents a promising frontier for mitigating embolic risks, optimizing procedural planning and patient safety in the evolving landscape of mitral valve interventions.
Manganiaris et al. (Thu,) reported a other. Mitral transcatheter edge-to-edge repair carries a peak periprocedural thromboembolic risk driven by device time, though near-universal subclinical ischemic lesions rarely cause overt deficits.