Estimating the quantitative effect of transcatheter mitral valve repair on functional parameters and quality of life is important for individual treatment decision-making.

36 observational studies and 1 randomized controlled trial were identified. Due to substantial heterogeneity of effect estimates (I ²-heterogeneity >75%) and inadequate quality of studies with a lack of comparison group in 97.4% and lack of an independent assessment of outcomes in 86.8%, no pooled estimates were calculated. All studies reported improvements of mean New York Heart Association (NYHA) class (0.5–1.9 classes), Short-Form (SF)-12/36 scores (4.4–9.2 for physical component score, 2.6–8.9 for mental component score), 6-min walk distance [(6MWD) 2–336 m] and Minnesota Living with Heart failure questionnaire (MLWHFQ) score (−7 to −18 points), with improvements regarded as clinically relevant in 20 of 29 studies for NYHA class, in all of 7 studies for SF12/36, in 9 of 15 studies for 6MWD and in all of 8 studies for MLWHFQ.

MitraClip therapy provides improvements in physical capacity, physical and mental functioning and disease-specific quality of life in the majority of patients. However, more comparative and high-quality studies are required for understanding the heterogeneity of results, which is crucial for optimal patient selection.