Transcatheter Edge-to-Edge Repair (TEER)

2025/02/13

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

Transcatheter Edge-to-Edge Repair (TEER) is a treatment technique used to repair a leaking mitral valve (Mitral Regurgitation). This is a non-invasive treatment alternative to an open-heart surgery.

Mitral valve TEER procedure:

May include the use of a mitral valve clip (MitraClip) - a device which NUHCS has been using in the treatment of mitral regurgitation.
Just recently, a new treatment method for transcatheter mitral valve repair with the use of a PASCAL device has been introduced.

What is the MitraClip or PASCAL Mitral TEER treatment?

A patient considered high risk for surgery or in cases where the patient prefers a non-surgical treatment method, the doctor may consider Percutaneous Coronary Intervention (PCI) using a MitraClip or PASCAL clip implant device.

This is a non-surgical approach and no chest incision will be needed during the procedure. The insertion of the device will be via a catheter – a pencil-like device which will be inserted through a vein in the leg. The implant, which is around 1-2 cm, will be advanced via the sheath to reach the mitral valve and treat the leaking or abnormal segment.

The procedure will be performed under the guidance of a special camera called “3D TEE”, which performs similar to a scope and a X-ray imaging. The patient will be under General Anaesthesia (GA) during the procedure.

What can one expect for a MitraClip or PASCAL Mitral TEER treatment?

The patient will be admitted to the hospital the day before the procedure, and will then be put under GA for two to three hours. After the procedure is completed, the patient will be monitored in the Intensive Care Unit (ICU) for at least one night. Older patients may require post-procedure cardiac rehabilitation.

A simple procedure may take two hours, and a complex procedure may require three to four hours. Follow-up clinical visits will be required.

What to prepare for this treatment?
• A couple of clinical visits will be arranged for the patient to consult a structural cardiologist
• Pre-procedure admission

Success rates:
An ideal anatomy success rate stands at 95%, but this may vary for more complex anatomy cases. The doctor will offer treatment options best suited for the patient’s condition.

Potential risks & complications:
As with all cardiac interventions, there are risks associated with the procedure. Although in general, the risks are lower as compared to an open-heart surgery.

The risks may include stroke, heart attack and other non-cardiac related risks such as kidney problems and access injury. Therefore, it is important that every patient is assessed by the medical team before a treatment option is considered.

Home care:
Generally, the patient will be given a couple of weeks of hospitalisation leave to ensure proper rest and care. Most patients should be able to do light walking once they are discharged from the hospital.

When to call the doctor:
If the patient experiences worsening of shortness of breath, swollen legs after being discharged from the hospital, or bleeding from the sheath access site, it is advised to see a doctor immediately.

Who is Mitral Valve TEER recommended for?

Mitral valve TEER is recommended for patients who are at an increased risk for open-heart surgery. These patients may include:

Elderly patients
Patients who have undergone previous heart surgery or other significant medical problems
Patients born with an abnormally-shaped mitral valve

Your healthcare professional will recommend treatment options that best fit your medical condition.