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Transcatheter Mitral Valve Repair (MitraClip / TEER)
Transcatheter edge-to-edge repair (TEER), often known by the device name MitraClip, treats a leaking mitral valve without open-heart surgery. A small clip is guided through a vein in the leg and fastened to the valve to reduce the leak.
What it is
The mitral valve sits between the heart's left upper chamber (left atrium) and the main pumping chamber (left ventricle). In mitral regurgitation, the valve does not close tightly, so blood leaks backward with every heartbeat. A severe leak can cause shortness of breath, tiredness, swelling, an irregular heartbeat called atrial fibrillation, and heart failure hospital stays. TEER uses one or more small clips to hold the two valve leaflets together where the leak is worst. The valve then closes more completely and leaks less.
Who it may help
TEER is mainly used for two groups. The first is people whose valve leaflets or their supports are damaged (degenerative or primary mitral regurgitation) and who face high risk with open surgery. The second is people with heart failure whose leak comes from an enlarged, weakened heart (secondary mitral regurgitation) and who still have symptoms despite full heart failure medical treatment. For many healthy patients with primary mitral regurgitation, surgical repair is still the standard. A transesophageal echocardiogram (TEE) shows whether the valve's shape is suitable for a clip.
How it's done
The procedure is done under general anesthesia. The doctor places a catheter in the large vein at the top of the leg, guides it to the heart, and crosses the thin wall between the two upper chambers to reach the mitral valve. TEE imaging, from an ultrasound probe in the esophagus, guides every step as the clip grasps the leaflets. The team checks the leak before releasing each clip. The procedure usually takes one to three hours.
Recovery
Most patients stay one night in the hospital and go home the next day or two. Plan to avoid heavy lifting for about a week, or as directed. You will have follow-up visits and echocardiograms, and you will keep taking your heart failure medicines. Many people notice easier breathing over the following weeks.
Risks
Possible risks include bleeding or injury to the leg vein, a remaining leak, narrowing of the valve opening, a clip that loosens from one leaflet, stroke, infection and irritation or injury from the TEE probe. Rarely, emergency surgery is needed or the procedure results in death. Your team will discuss your own risks.
Dr. Smith's experience
Dr. Smith trained in interventional cardiology and structural heart disease at the University of Alabama at Birmingham. He has been primary operator for more than 25 transcatheter mitral repairs since joining Cardiovascular Institute of the South in 2023, among more than 180 structural heart procedures. He is board certified in echocardiography, the imaging that guides each clip. He also performs mitral balloon valvuloplasty for selected patients with a narrowed mitral valve.
Frequently asked questions
Is MitraClip open-heart surgery?
No. The clip is delivered by catheter through a vein at the top of the leg. The chest is not opened and the heart keeps beating during the procedure.
Will the leak go away completely?
The goal is to reduce the leak, often substantially. Some leak may remain. Your doctor will review the expected result based on your valve's shape.
How long will I be in the hospital?
Most patients stay one night. Some need longer, depending on their overall health.
Why do I need a transesophageal echocardiogram (TEE)?
A TEE gives a close, detailed view of the mitral valve from the esophagus, just behind the heart. It shows whether a clip is likely to work and guides the procedure itself.
Will I still need my heart failure medicines?
Yes. TEER treats the valve leak, but heart failure medicines remain important. Your cardiologist may adjust them after the procedure.
Can I have TEER if I have atrial fibrillation?
Often, yes. Atrial fibrillation is common in people with mitral regurgitation. Your blood-thinning plan will be reviewed before and after the procedure.
Ask about mitral valve repair (MitraClip) at Cardiovascular Institute of the South
Dr. Smith sees patients at CIS Baton Rouge, 8401 Picardy Avenue · (225) 308-0247, and CIS Zachary, 6550 Main Street, Suite 1000 · (225) 654-1559. Your primary care doctor or cardiologist can also send a referral.