
Mitral annular dilation has been shown to challenge successful edge-to-edge therapy with earlier MitraClip generations. Recently, third-generation MitraClip-XTR with extended clip arm length was introduced. We assessed the impact of annular dilation on residual mitral regurgitation (MR) after MitraClip-XTR repair and sought to identify cutoffs associated with suboptimal MR reduction. Annular dilation was found to challenge successful edge-to-edge therapy also with extended-reach MitraClip-XTR. Our proposed thresholds for preprocedural annular dimensions may serve as guidance for improved patient selection in edge-to-edge repair.
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