Pulmonary hypertension (PH) is common in patients undergoing transcatheter mitral valve edge-to-edge repair (mTEER), yet its impact on outcomes remains unclear. At the 2025 European Society of Cardiology (ESC) Congress, investigators presented findings demonstrating that residual PH after mTEER is a key predictor of adverse clinical outcomes.

This retrospective study included 158 patients (mean age 76 years) with a median follow-up of 330 days. Baseline PH, defined as right ventricular systolic pressure (RVSP) ≥50 mmHg, was present in 77 patients, of whom 37 (48.1%) had post-procedure improvement below this threshold. Patients with residual PH had a significantly higher risk of the composite endpoint of all-cause mortality and heart failure hospitalizations (hazard ratio 2.55, 95% CI 1.06–6.17).

Among patients undergoing right heart catheterization, elevated pulmonary vascular resistance (PVR >2 Wood units) was not associated with adverse outcomes. These findings suggest that dynamic reduction in PH, rather than baseline PVR, is crucial for prognostication following mTEER.