When facing mitral or tricuspid valve regurgitation, patients today have more treatment options than ever before. Among the most promising is the TEER procedure (Transcatheter Edge-to-Edge Repair), a minimally invasive approach that’s transforming how we treat heart valve conditions. This detailed blog will explore everything you need to know about TEER risks, the Transcatheter Edge-to-Edge Repair procedure, TEER cost, and TEER recovery.
The TEER procedure is a groundbreaking minimally invasive treatment for mitral and tricuspid valve regurgitation, a condition where the valve between the heart’s atria and ventricles does not close properly. Instead of requiring open-heart surgery, this minimally invasive technique uses a catheter-based approach to repair the valve inside the heart.
During the procedure, specialised devices like the MitraClip and MyClip (for mitral valves) or TriClip (for tricuspid valves) are inserted through an artery, usually in the groin, using a thin, flexible tube called a catheter. These devices function by pulling the flaps of the valves into better alignment, helping the valve close tightly and restore normal blood flow.
Like any medical procedure, the TEER procedure carries certain risks that patients should understand before making treatment decisions. However, research shows that TEER generally has a favourable safety profile compared to traditional surgery.
The immediate TEER risks following the procedure are relatively low, making it a suitable option for high-risk patients who cannot undergo traditional open-heart surgery.
Bleeding represents one of the primary short-term TEER risks. Most bleeding complications occur within the first few hours after the procedure, which is why careful monitoring during this critical period is essential. Major bleeding requiring blood transfusion can occur, though it affects only a small percentage of patients.
Serious cardiac complications include pericardial tamponade (heart compression from fluid buildup) and stroke. While these are concerning complications, they occur infrequently and at rates significantly lower than those associated with surgical valve repair.
Among the specific TEER risks are device complications, such as a single-leaflet device attachment, where the clip doesn’t attach properly to both valve leaflets. Clip detachment or embolisation (device migration) is a rare but serious event that may require emergency intervention.
Understanding long-term TEER risks is crucial for setting realistic expectations about the procedure’s durability and outcomes.
Long-term survival varies based on patient health and the underlying cause of valve disease. Patients with heart failure-related mitral regurgitation face higher long-term mortality risks compared to those with primary valve disease. However, this often reflects the severity of their overall heart condition rather than the procedure itself.
One of the key long-term TEER risks involves the potential need for repeat interventions. Some patients may require follow-up mitral valve procedures, with many ultimately needing valve replacement rather than repeat repair. The time between the initial TEER procedure and any required reintervention varies considerably.
Residual or recurrent mitral regurgitation can develop over time, occurring more frequently than after surgical repair. However, the majority of patients maintain sustained valve improvement for several years following the procedure.
Despite these TEER risks, the procedure offers significant advantages for carefully selected patients, particularly those at high surgical risk.
The Transcatheter Edge-to-Edge Repair procedure offers numerous advantages that make it a go-to option for many patients with mitral valve regurgitation.
TEER is performed through a small catheter insertion, avoiding the need to open the chest or
stop the heart. This approach significantly reduces physical trauma and pain compared to open-heart surgery.
Most patients spend only a day or two in the hospital and return to their normal activities much faster than with traditional surgery. The minimally invasive nature of TEER also lowers the risk of wound infections and other surgical complications.
TEER achieves excellent procedural success, with nearly all patients experiencing a significant reduction in their valve leak. Many patients notice immediate improvements in heart function and symptoms shortly after the procedure.
Over time, patients typically experience marked relief from shortness of breath and fatigue, allowing them to resume daily activities and exercise more comfortably. This improvement often leads to reduced anxiety and a better sense of overall well-being.
TEER helps many patients improve their functional class, making routine tasks and physical activity easier. Standard quality-of-life assessments consistently show meaningful gains in both physical and mental health scores following the procedure.
By reducing the leak through the mitral valve, TEER promotes favourable changes in heart structure and function. It helps decrease pressure on the lungs and lowers the overall workload on the heart, which contributes to a lower likelihood of future heart failure hospitalisations.
These immediate and long-term benefits make TEER an appealing treatment option for appropriately selected patients, combining the safety of a minimally invasive procedure with durable improvements in symptoms and cardiac health.
For suitable patients, TEER offers several advantages compared to traditional surgical closure:
Understanding TEER cost is crucial for patients considering this procedure. While specific costs can vary significantly based on location, insurance coverage, and individual circumstances, several factors influence the overall expense. Typically, the procedure using MitraClip or MyClip for mitral valve repair ranges from ₹21 to ₹32 lakhs in India.
TEER recovery is generally much faster and easier compared to traditional open-heart surgery, making it an attractive option for many patients.
| Recovery Phase | Key Aspects | Details |
| Immediate Post-Procedure (First 24–48 Hours) | Hospital Stay | Most patients stay 1–2 days for monitoring. Continuous cardiac monitoring ensures a stable heart rhythm, with regular echocardiograms to assess valve function. Pain management is provided, with minimal discomfort expected. |
| Early Mobility | Patients can usually sit up within hours of the procedure. Walking is encouraged within 24 hours, with gradual activity increase as tolerated. | |
| Short-Term Recovery (First 2–4 Weeks) | Activity Restrictions | Avoid heavy lifting (>10 pounds) for 1–2 weeks. Driving is restricted for several days to a week, depending on medications. Patients gradually return to normal daily activities. Follow-up appointments are usually scheduled within 1–2 weeks. |
| Symptom Improvement | Many patients notice improved breathing within days, along with reduced fatigue and increased energy. Better exercise tolerance typically develops over weeks. | |
| Long-Term Recovery (1–3 Months and Beyond) | Sustained Improvements | Continued improvement in heart function, enhanced quality of life, and the ability to return to previous or better activity levels. Regular follow-up appointments monitor valve function. |
| Medication Management | Patients continue heart failure medications as prescribed, and anticoagulation therapy may be adjusted depending on individual response and comorbidities. Regular monitoring of kidney and liver function is also recommended to ensure safe and effective recovery. |
Ideal Candidates for TEER
Ideal candidates include patients with severe mitral regurgitation who continue to experience symptoms despite optimal medical therapy. Those with high or prohibitive surgical risk, suitable valve anatomy for clip placement, and a life expectancy greater than one year are considered appropriate for the procedure.
Anatomical requirements include adequate leaflet length and mobility, absence of severe calcification in the gripping area, and an appropriate valve area to avoid stenosis after repair.
Making the Decision: TEER vs. Traditional Surgery
When considering treatment options for mitral valve regurgitation, patients and their healthcare teams must weigh several factors. TEER offers a minimally invasive approach with faster recovery, lower 30-day mortality risk, suitability for high-risk surgical candidates, and excellent symptom improvement and quality of life benefits.
In contrast, traditional surgery may provide lower long-term reintervention rates, better long-term survival in some patients, more durable repair in appropriate candidates, and greater improvement in functional capacity.
The TEER procedure represents a significant advancement in treating mitral valve regurgitation. With its minimally invasive approach, excellent safety profile, and proven benefits for symptom relief and quality of life, TEER has become an important treatment option for patients who might otherwise face high-risk surgery or no treatment at all. While TEER risks include the possibility of reintervention and some procedural complications, most patients find these acceptable given the procedure’s less invasive nature and faster TEER recovery. The TEER cost, though significant, must be weighed against the benefits of reduced hospital stays, lower immediate risks, and quicker return to normal activities.
If you’re considering treatment for mitral valve regurgitation, discuss with our cardiologist at Heart Valve Experts whether the TEER procedure might be appropriate for your specific situation. With proper patient selection and experienced operators, TEER can provide excellent outcomes and help you return to a more active, comfortable life.
Yes, TEER is commonly performed using devices like MitraClip or MyClip to repair the mitral valve without open-heart surgery.
TEER has a high success rate, with most studies reporting significant improvement in valve function and symptoms in over 90% of patients.
Patients typically recover quickly, often resuming normal activities within a few days to a couple of weeks, depending on overall health.
Most patients stay in the hospital for 1–2 days for monitoring and early recovery after TEER.
The TEER procedure usually takes around 1–2 hours, depending on the complexity of the case
