Our Summary

This paper reviews the use of a specific heart valve repair technique, called transcatheter edge-to-edge mitral valve repair (TEER). It’s becoming more common to use this technique in younger patients and those with a lower risk of surgery. However, it’s important to understand the outcomes when this procedure fails and the patient needs further surgery.

The research found that after a failed TEER procedure, it was often difficult to repair the mitral valve again, and replacement of the valve was usually needed. These follow-up surgeries had high rates of early and late death, likely due to the patients’ underlying health conditions and the urgency of the surgery.

The study also found that the success of the repair and the reduction of risks during surgery were influenced by the experience of the medical center and surgeon.

Surgical mitral valve repair is still considered the most effective and safest treatment for degenerative mitral disease. Given the high risk of needing a valve replacement if TEER fails, the use of this technique should be carefully considered in younger or lower-risk patients.

FAQs

  1. What is the transcatheter edge-to-edge mitral valve repair (TEER) technique?
  2. What are the possible outcomes if a TEER procedure fails?
  3. How does the experience of the medical center and surgeon influence the success of the mitral valve repair?

Doctor’s Tip

It’s important to follow up regularly with your doctor after mitral valve repair to monitor your heart health and ensure the repair is successful. Be sure to discuss any symptoms or concerns you may have with your doctor promptly. Additionally, maintaining a healthy lifestyle with regular exercise, a balanced diet, and avoiding smoking can help support your heart health post-surgery.

Suitable For

Patients who are typically recommended mitral valve repair are those with degenerative mitral disease, such as mitral regurgitation or mitral valve prolapse. This includes younger patients and those with a lower risk of surgery who may benefit from a less invasive procedure like TEER. It is important for patients to be carefully evaluated by a cardiac surgeon to determine the best treatment option based on their individual health status and the severity of their condition.

Timeline

Before mitral valve repair:

  1. Patient experiences symptoms such as shortness of breath, fatigue, and heart palpitations.
  2. Patient undergoes diagnostic tests such as echocardiogram and cardiac catheterization to confirm mitral valve disease.
  3. Patient consults with a cardiac surgeon to discuss treatment options, including mitral valve repair.

After mitral valve repair:

  1. Patient undergoes minimally invasive or open-heart surgery to repair the mitral valve.
  2. Patient is monitored closely in the hospital for any complications post-surgery.
  3. Patient undergoes cardiac rehabilitation to regain strength and improve heart function.
  4. Patient follows up with cardiologist for regular check-ups and monitoring of the repaired mitral valve.
  5. Patient experiences improvement in symptoms such as improved exercise tolerance and reduced risk of heart failure.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with transcatheter edge-to-edge mitral valve repair (TEER)?
  2. What are the success rates of TEER compared to traditional surgical mitral valve repair?
  3. How experienced is the medical center and surgeon in performing TEER procedures?
  4. What factors increase the likelihood of needing a valve replacement if TEER fails?
  5. What are the long-term outcomes and survival rates for patients who require follow-up surgery after a failed TEER procedure?
  6. Are there alternative treatment options available for mitral valve repair?
  7. How will the decision to undergo TEER or traditional surgery be personalized based on my individual health condition and risk factors?
  8. What post-operative care and follow-up will be necessary after undergoing mitral valve repair?

Reference

Authors: El-Eshmawi A, Costa AC, Boateng P, Pandis D, Israel Y, Adams DH, Tang GHL. Journal: Curr Opin Cardiol. 2023 Mar 1;38(2):143-148. doi: 10.1097/HCO.0000000000000991. Epub 2022 Sep 28. PMID: 36200272