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Functional mitral regurgitation(FMR) most commonly arises from underlying left ventricular (LV) dysfunction and dilatation with tethering of the mitral leaflets (vFMR). However, a distinct subtype known as aFMR is characterized by left atrial (LA) enlargement (often resulting from long-standing atrial fibrillation [AF] or myopathy) with primary mitral annular dilatation in the absence of LV dysfunction. 1 Whether transcatheter edge-to-edge repair (TEER) is effective for aFMR is unknown. We therefore performed a systematic review and metaanalysis to assess the outcomes of TEER in patients with aFMR compared with vFMR. Two independent reviewers (EM, KG) performed a systematic search of Medline, Embase, and Cochrane databases from inception through December 2022 to identify studies that: 1) evaluated adult patients who underwent TEER using the MitraClip system for FMR; 2) compared results of TEER in …