Efficacy and Safety of Transcatheter Mitral Valve Repair (MitraClip) Compared to Medical Therapy and Surgery in Patients with Secondary Mitral Regurgitation: A Systematic Review & Pairwise Meta-Analysis

In contemporary RCTs, MitraClip on top of GDMT lowers mortality and HF hospitalizations and improves quality of life in SMR. Compared with surgery, TMVr offers a superior early safety profile with similar MR reduction at ~1 year. These results support Heart-Team use of MitraClip after optimized GDMT in anatomically suitable SMR, while reserving surgery for selected scenarios.