Risk of stroke, atrial fibrillation, and major bleeding after mitral valve repair: the jury is still out

In recent years, edge-to-edge transcatheter mitral valve repair (TMVR) has emerged as an acceptable therapeutic option for inoperable or high surgical risk patients suffering from severe mitral valve regurgitation1,2,3. The main advantages of TMVR over traditional surgical approaches – hereinafter referred to as surgical mitral valve repair (SMVR) – are its limited invasiveness and favourable safety profile, though clinical outcomes and functional cardiac parameters remain significantly inferior at long-term follow-up1,2.

In large registries, the incidence of clinically overt stroke after TMVR is reported to be very low, ranging from 0.2% to 0.4% at discharge and from 0.7% to 0.8% at 30 days4,5,6,7. However, ...