TEER

A TEER (transcatheter edge-to-edge repair) procedure fixes a heart valve that isn’t working right. Healthcare providers can use it for your mitral valve or tricuspid valve. They clip together valve leaflets that aren’t closing properly. This can repair a valve that lets blood leak backward. It should only flow forward.

You may have this minimally invasive procedure if your case is severe or if surgery would be too risky for you. A provider may say surgery is risky because of other medical problems you have. TEER is less invasive than surgery because it uses a catheter through your veins. But TEER isn’t the right treatment for everyone.

How should I prepare for TEER?

Before this procedure, you may need to have certain tests, like:

• Physical exam
• Test of how far you can walk in six minutes (six-minute walk test)
• Test to check your heart and lung function (cardiopulmonary exercise test)
• Ultrasound of your heart (echocardiogram)
• CT scan of your heart
• Test to show how well blood moves in your heart’s arteries (coronary angiogram)
• Test that tells how well your heart can pump (right heart catheterization)

Your healthcare provider may ask you to start taking a blood thinner before your procedure.

What happens during this procedure?

During a procedure that takes about two hours or less, your healthcare team will:

1. Give you general anesthesia.
2. Insert a catheter into the femoral vein in your groin.
3. Work the catheter up to and into your heart.
4. Put the catheter through the wall between your upper heart chambers, if needed.
5. Set up X-ray or ultrasound imaging to guide clip placement.
6. Place one or more metal clips on the leaky leaflet edges that face each other.
7. Remove the catheter.
8. Close the hole in your femoral vein and put pressure on it.
9. Check your heart after the procedure with an echocardiogram.

What are the potential benefits and risks of this procedure?

Benefits of a TEER procedure include:

• Safe option for people who can’t have surgery
• Less severe valve leak
• Improved symptoms
• Ability to walk a longer distance in the six-minute walk test
• Lower chance of needing a hospital stay for heart failure

Any procedure has risks. The risks of a TEER cardiac procedure include:

• Bleeding
• Infection
• Blood clots
• Air blockage of a blood vessel
• Buildup of fluid around your heart (pericardial effusion)
• Metal clip detachment
• Abnormal heart rhythm
• A hole in your heart wall from the procedure doesn’t close
• Narrowing (stenosis) of your valve
• Injury to a valve leaflet

What happens after this procedure?

You’ll most likely need to lie still on your back for several hours after TEER. You may spend one or two days in the hospital after the procedure.

Once you go home, you’ll need to rest and avoid exerting yourself for several days. You may be able to return to working and driving in about a week. Check with your provider to be sure.

Follow-ups

You can expect to have follow-up visits with your healthcare team after your procedure. You’ll probably have echocardiograms to check how well the repair is working.

When should I call my healthcare provider?

Contact your provider if you have:

• An infection or bleeding where the catheter was
• Fever or chills
• Changes in the color of your leg’s skin
• Warmth or pain where the catheter went in