Percutaneous Mitral Valve Edge-to-Edge Repair is a minimally invasive procedure used to treat mitral regurgitation, a condition in which the mitral valve does not close properly and allows blood to leak backwards within the heart.
For patients who may not be suitable candidates for open-heart surgery, catheter-based procedures can significantly reduce valve leakage, improve symptoms and enhance quality of life. Both conventional cardiac surgery and mitral transcatheter procedures can be done at Southampton Spire. Our current cardiology consultants that do mTEER and TMVR are Professor Michael Mahmoudi and Dr James Wilkinson. mTEER and TMVR procedures are complex and always need two consultant cardiologists (usually Professor Michael Mahmoudi and Dr James Wilkinson), as well as a consultant to do a TOE study (Dr Paul Diprose) and a consultant anaesthetist.
The image on the left shows Dr James Wilkinson and Professor Michael Mahmoudi doing TEER procedure putting clip into system
UNDERSTANDING MITRAL REGURGITATION AND STENOSIS
The mitral valve sits between the left atrium and left ventricle and helps ensure blood flows in the correct direction through the heart.
When the valve becomes damaged or fails to close fully, blood can leak backwards, forcing the heart to work harder and potentially causing symptoms as listed below. Mitral stenosis is where there is significant narrowing and causes virtually identical symptoms. The symptoms experienced in mitral valve disease include:
- Breathlessness
- Fatigue
- Reduced exercise tolerance
- Swollen ankles
- Palpitations
MITRAL VALVE EDGE-TO-EDGE REPAIR (mTEER)
How Does the Procedure Work?
A specialised device is delivered to the mitral valve through a catheter inserted via a vein, typically in the groin.
The device brings portions of the valve leaflets together, reducing the amount of leakage while preserving normal blood flow through the valve.
The procedure is performed under advanced imaging guidance by a specialist structural heart team.
BENEFITS OF MITRAL VALVE EDGE-TO-EDGE REPAIR
- Minimally invasive treatment
- Avoids open-heart surgery for suitable patients
- Improved symptoms and quality of life
- Reduced breathlessness and fatigue
- Shorter recovery period compared with surgery
ASSESSMENT AND SUITABILITY FOR mTEER
Detailed imaging studies, including echocardiography and other cardiac investigations, are used to determine whether the valve anatomy is suitable for edge-to-edge repair.
RECOVARY FROM mTEER
Most patients are able to return home, often the following day, although rarely a longer stay is needed and notice gradual improvements in symptoms over the following weeks and months.
TEER equipment
Photo of complex TEER equipment controls with x-ray imaging on screen as well as TOE ultrasound images of heart to guide procedure to clip mitral valve.
TEER case happening
Photo of complex Dr Wilkinson and Professor Mahmoudi putting TEER clip on valve with x-ray imaging on screen as well as TOE ultrasound images of heart to guide procedure.
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