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Heart health is central to overall well-being, and when something as vital as the mitral valve doesn’t function properly, it can lead to significant challenges. Mitral valve regurgitation—a condition where the valve between the heart’s left chambers doesn’t close fully—can strain the heart, cause symptoms like shortness of breath and fatigue, and increase the risk of severe complications if untreated. A cutting-edge treatment, Mitral Transcatheter Edge-to-Edge Repair (TEER), offers hope for patients with this condition.

Let’s delve into what TEER is, how it works, and why it’s transforming care for heart valve issues.

What is Mitral Valve Regurgitation?

The mitral valve plays a crucial role in controlling blood flow within the heart. In a healthy heart, this valve ensures blood flows in one direction—from the left atrium to the left ventricle. However, in mitral valve regurgitation, the valve doesn’t seal tightly, allowing blood to flow backward. This forces the heart to work harder to maintain circulation, potentially leading to:

  • Increased lung pressure, causing breathlessness.
  • Fatigue, as the heart struggles to supply oxygen-rich blood to the body.
  • Heart failure, if the condition progresses without intervention.

What is Mitral Transcatheter Edge-to-Edge Repair (TEER)?

TEER is a minimally invasive procedure that helps restore proper valve function and alleviate symptoms of mitral valve regurgitation. It uses advanced technology—such as the Abbott MitraClip or Pascal Precision system—to reduce the backward flow of blood.

Instead of traditional open-heart surgery, TEER involves the insertion of a device through a catheter, requiring only a small incision in the groin. The procedure realigns the mitral valve flaps, ensuring better closure and reducing the strain on the heart.

 

Key Benefits of TEER

TEER provides multiple advantages for patients, including:

  1. Minimally Invasive Approach: A small incision reduces recovery time and minimizes complications compared to open-heart surgery.
  2. Symptom Relief: TEER alleviates symptoms like shortness of breath, chest pain, and fatigue, enhancing quality of life.
  3. Reduced Hospitalizations: Patients undergoing TEER have a lower risk of being re-hospitalized for heart failure.
  4. Improved Mental Well-being: With better heart function, patients often experience reduced anxiety and improved overall outlook.

Who is a Candidate for TEER?

TEER is often recommended for patients who:

  • Have moderate to severe mitral valve regurgitation.
  • Are unsuitable for open-heart surgery due to age, existing medical conditions, or other risk factors.
  • Need an alternative to surgery for quicker recovery.

However, determining eligibility requires thorough evaluation by a heart specialist.

Diagnostic Tests for TEER Eligibility

Before proceeding with TEER, your healthcare team will conduct several diagnostic tests to assess your heart’s condition:

  1. Coronary Angiogram: Provides detailed images of the coronary arteries and measures heart chamber pressures using a catheter and contrast dye.
  2. Echocardiogram: Uses sound waves to create detailed images of the heart. Both transthoracic (external) and transesophageal (internal) echocardiograms may be used for clearer imaging.
  3. Vascular Ultrasound: Evaluates blood flow through veins and arteries to identify any blockages or abnormalities.
  4. Blood Tests: Assess organ function, electrolyte levels, and possible causes of heart issues.

Once all test results are reviewed, a team of cardiologists, interventional cardiologists, heart surgeons, and imaging specialists will decide if TEER is the right treatment.

How is TEER Performed?

TEER is performed in a specialized cardiac catheterization lab and typically takes 2–3 hours under general anesthesia. Here’s an overview of the procedure:

  1. Accessing the Heart:
    • A small incision is made in the groin to access the femoral vein.
    • A catheter is threaded through this vein to reach the heart.
  2. Crossing to the Mitral Valve:
    • Using imaging guidance (X-ray and ultrasound), a tiny hole is made in the heart’s septum to pass the catheter to the mitral valve.
  3. Implanting the Device:
    • The MitraClip or Pascal device is delivered through the catheter and placed on the mitral valve flaps.
    • The device brings the flaps closer, improving valve closure and reducing blood backflow.
  4. Completion:
    • Once the device is positioned and functioning correctly, the catheter is removed, and the incision site is sealed.

Recovery After TEER

Patients typically experience a quicker recovery compared to traditional surgeries. Here’s what to expect:

  1. Hospital Stay:
    • Most patients spend 1–2 nights in the hospital.
    • Immediate post-procedure monitoring occurs in the post-anesthesia care unit or intensive care unit.
  2. Follow-up Tests:
    • Tests like chest X-rays, blood work, EKG, and echocardiograms ensure the device functions properly.
  3. Mobility:
    • Patients are encouraged to start walking within 24 hours to promote circulation and recovery.
  4. Home Care:
    • You’ll receive instructions on managing the incision site, dietary changes, medications (like blood thinners), and activity levels.

Long-Term Benefits of TEER

TEER not only alleviates symptoms but also offers long-term benefits:

  • Enhanced Heart Function: Reduces strain on the heart, preventing complications like heart failure.
  • Improved Quality of Life: With reduced symptoms, patients can return to daily activities with more energy and confidence.
  • Lower Risk of Future Complications: Prevents the progression of mitral valve regurgitation, reducing the likelihood of re-hospitalization.

Related Conditions Treated by TEER

  1. Mitral Valve Regurgitation: TEER directly addresses this condition by improving valve function.
  2. Heart Failure: By reducing the workload on the heart, TEER helps manage symptoms associated with heart failure.

FAQs About Mitral Transcatheter Edge-to-Edge Repair

1. Is TEER a permanent solution for mitral valve regurgitation?
Yes, TEER provides a long-term solution, though follow-up care and monitoring are essential to ensure continued effectiveness.

2. How soon can I return to normal activities after TEER?
Most patients can resume light activities within a few days and return to normal routines within a week, depending on their overall health.

3. Are there risks associated with TEER?
As with any medical procedure, there are risks such as infection, bleeding, or device-related complications, but these are relatively rare.

4. Can TEER be performed on all patients with mitral valve regurgitation?
Not all patients are candidates for TEER. A thorough evaluation by your heart team will determine if it’s suitable for you.

5. What is the success rate of TEER?
TEER has a high success rate, with most patients experiencing significant symptom relief and improved heart function.

6. Will I need blood thinners after TEER?
In many cases, patients are prescribed blood thinners to prevent clots. Your doctor will provide personalized recommendations.

 

Dr. Sanjeev Gera

MBBS, MD – Medicine, DNB – Cardiology

Cardiologist | 20 Years Experience

Fortis Institute of Cardiovascular Sciences, Rasoolpur Nawada, Industrial Area, Sector 62, Noida, Uttar Pradesh 201301

Monday – Saturday | 8AM – 5PM