To clip or not to clip? A review of precise risk assessment in the contemporary era of transcatheter edge-to-edge mitral and tricuspid valve repair

Transcatheter edge-to-edge mitral and tricuspid valve repair (M-TEER, T-TEER) have emerged as meaningful treatment modalities among patients at high surgical risk suffering from valvular heart disease. While previous research has shown that optimal patient selection is crucial for treatment outcomes, recent studies have identified a multitude of factors that independently influence mortality. Although these findings can significantly support clinical decision-making, the large number of available studies renders an overview of this topic challenging. In this review, we provide a comprehensive overview of the currently identified factors associated with increased mortality after TEER. We also summarize the current evidence on published risk scores that stratify mortality risk after M-TEER and T-TEER. We aimed to provide clinical decision-making support for optimal patient selection and referral to TEER and to identify remaining gaps in evidence.