What is mTEER?
The mitral valve controls blood flow between the upper and lower chambers on the left side of your heart. When it does not close properly, blood can leak backwards. This is called mitral regurgitation.
Mitral transcatheter edge-to-edge repair, or mTEER, holds parts of the valve’s two leaflets together. MitraClip and PASCAL are examples of devices used for this approach. The aim is to reduce leakage and improve symptoms such as breathlessness; the leak may not disappear completely.
Who may benefit?
mTEER may help selected people with severe, symptomatic leakage whose valve anatomy is suitable, particularly when surgery would carry a high risk or is unsuitable.
The leak may arise from a problem with the valve itself, or because the heart has enlarged or weakened. If heart failure is contributing, medicines and other appropriate heart-failure treatment need careful review first.
A Heart Team, including specialists in valve imaging, catheter treatment and surgery, compares the options. Detailed ultrasound scans, often including a scan through the gullet (TOE), assess whether the leaflets can be brought together safely.
What happens during treatment?
- Anaesthetic: treatment is usually performed under general anaesthetic, so you are asleep.
- Access: a catheter passes through a groin vein. A small puncture through the wall between the upper heart chambers allows access to the mitral valve.
- Repair: ultrasound and X-rays guide one or more devices into position. The team checks how much leakage remains and that blood can still flow through the valve.
- Afterwards: you are monitored, and a heart scan assesses the result.
Recovery & ongoing care
A hospital stay of one to three days is common, although some people need longer. Bruising and tiredness can occur. Build up walking gradually and follow your team’s instructions about lifting, exercise, work and driving.
Keep taking your prescribed heart medicines. Repair does not usually replace the need for heart-failure treatment. Any antiplatelet or anticoagulant medicine is tailored to your circumstances; ask before making changes.
Follow-up appointments and ultrasound scans check the repair and remaining leakage. Continue dental care, tell your dentist about the repair device, and ask the valve team about precautions for dental treatment.
Sources: [3]
Risks & alternatives
Risks include bleeding or blood-vessel injury, blood collecting around the heart, damage to the valve, partial device detachment, and narrowing of the valve opening. Leakage may remain or return. Stroke, infection, emergency surgery and death are serious possible complications. The ultrasound probe and anaesthetic also have risks.
Surgical repair or replacement may offer a better result when surgery is suitable. Medicines and other heart-failure treatments remain important; some people benefit most from symptom-focused care. Your team will discuss personal risks and whether further treatment could be needed.
Common questions
Is the mitral valve replaced?
No. mTEER repairs your existing valve by joining part of its leaflets. A replacement valve is a different treatment.
Will all the leakage be gone?
Not always. Reducing the leak can help symptoms even when some remains. Follow-up scans monitor the result.
Is mTEER suitable for every leaking valve?
No. The cause and position of the leak, leaflet structure, valve opening and your wider health all affect suitability. An individual Heart Team assessment is needed.
When to get help
Call 999 for severe or persistent chest pain, severe breathlessness, collapse or signs of a stroke: face drooping, arm weakness or speech difficulty, even if they improve. A newly cold, pale or numb arm or leg on the catheter side also needs emergency help. For heavy or persistent wound bleeding, lie down, apply firm pressure and call 999. Do not drive yourself to A&E.
Contact your treating team promptly for fever, worsening wound redness or swelling, new palpitations or increasing breathlessness. If you cannot reach them, contact NHS 111. Do not wait for a routine private appointment.
Sources & further reading
- Leeds Teaching Hospitals: mitral TEER patient guide
- NICE: heart valve disease recommendations
- Leicester’s Hospitals: mitral TEER information and recovery (PDF)
- NICOR: mitral valve procedures and devices
- Abbott: MitraClip safety information
This general guide supports discussion with your care team. It does not replace your individual assessment, consent discussion or hospital discharge instructions. Hospital protocols and recovery times vary.
Discuss your next step
Dr Faisal Khan offers general and specialist cardiology consultations in London and Surrey. Bring your questions, medicines list and any relevant test results. If a procedure is appropriate, the team will confirm the treatment location and arrangements.
Arrange a consultation