Less is known about long-term relative survival after transcatheter edge-to-edge repair (TEER) compared with expected survival in the general population. In a retrospective analysis presented at the EuroPCR 2026, investigators evaluated relative survival and excess mortality after TEER, with particular focus on sex-related differences.

The study included consecutive patients undergoing transcatheter edge-to-edge repair for significant mitral regurgitation between 2015 and 2024. Observed survival was estimated using actuarial life tables, while expected survival was derived from age-, sex-, and region-matched population data using the Ederer II method.

Findings

• Observed survival after TEER was 88.9% at 1 year, 87.4% at 2 years, and 78.9% at 3 years.
• Excess mortality was highest during the first year after the procedure.
• After the initial year, excess mortality progressively decreased and approached rates observed in the general population.
• Men demonstrated persistently lower relative survival compared with matched population controls during follow-up.
• The excess mortality observed in men appeared to be driven primarily by early post-procedural risk.
• In contrast, women achieved relative survival comparable to the general population beginning within the first year after TEER.
• Women did not demonstrate significant excess mortality during follow-up.
• After multivariable adjustment, sex was not identified as an independent predictor of mortality.

The findings suggest that mortality risk after transcatheter edge-to-edge mitral repair is concentrated during the early post-procedural period, with notable differences in relative survival patterns between men and women.