Data on mitral valve transcatheter edge-to-edge repair (M-TEER) in Asian patients are limited. This study evaluates the anatomical suitability and clinical efficacy of M-TEER in Chinese patients with moderate-to-severe or severe mitral regurgitation (MR).目的：亚洲患者二尖瓣经导管缘对缘修复术（M-TEER）的数据有限。本研究评价了M-TEER在中国中重度或重度二尖瓣返流（MR）患者中的解剖学适用性和临床有效性。方法：本研究纳入了2021年1月至2024年2月在阜外医院接受M-TEER超声心动图筛查的中重度或重度二尖瓣返流的症状性患者。根据M-TEER的当前解剖学标准对患者进行分类。总结了临床特征、超声心动图参数和治疗，重点关注M-TEER的手术成功率和1年MR复发率。结果：共入组481例患者，其中退行性MR（DMR

This study included symptomatic patients with moderate-to-severe or severe MR who underwent M-TEER echocardiographic screening at Fuwai Hospital from January 2021 to February 2024. Patients were classified according to current anatomical criteria for M-TEER. Clinical characteristics, echocardiographic parameters, and treatments were summarized, focusing on the procedural success of M-TEER and 1-year MR recurrence rates.

 A total of 481 patients were enrolled, including 304 with degenerative MR (DMR) and 150 with functional MR (FMR). The average age was 68.81 years, 44.28% were female, and 70.69% had severe MR. DMR patients had smaller absolute left atrial and ventricular diameters compared to FMR patients. Ideal, suitable, challenging, and impossible M-TEER anatomy was found in 23.49%, 36.17%, 13.93%, and 26.4% of patients, respectively. Among those who underwent M-TEER, these proportions were 36%, 46%, 15%, and 3%. The 1-year cumulative incidence of MR recurrence was similar between different etiologies but significantly lower in patients with ideal/suitable anatomy compared to those with challenging/impossible anatomy (5.28% vs 11.86%, P=0.003). Multivariable analysis showed that a leaflet-to-annulus index of <1.2 increased the risk of MR recurrence within one year by 478%.

Among patients with significant MR, 59.66% had ideal/suitable M-TEER anatomy, but only 48% received treatment, indicating potential undertreatment. Patients with ideal/feasible anatomy had higher procedural success rates and lower recurrence risks.