Majority of patients who needed surgery after failed TEER required mitral valve replacement

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A new study, presented today at the AATS 101st Annual Meeting, and simultaneously published in the Journal of the American College of Cardiology, finds that patients suffering from severe mitral regurgitation should be carefully screened and counselled before undergoing transcatheter edge-to-edge mitral repair (TEER).

Data showed that up to 95 percent of patients who needed surgery after failed TEER could not have their valves repaired, and needed mitral valve replacement to resolve the issue. The findings highlight the need to select patients carefully for TEER.

As a less invasive approach, TEER is an attractive alternative treatment to mitral valve surgery, particularly in older patients. However, TEER is not currently recommended for younger patients who benefit more from a surgical repair long-term. This caution is supported by this study of 463 patients which provides the first national data on surgical outcomes when TEER fails. The surgical repair rate after failed TEER was only 4.8 percent overall, and 6.8 percent in degenerative disease.

The fact that TEER takes surgical repair off the table as an option for patients makes it essential that we have a very clear understanding of which patients will benefit. This finding has important implications for treatment choice in lower-risk patients with degenerative disease.”

Dr. Joanna Chikwe, Chair, Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai

“These findings should inform patient consent for TEER, design of clinical trials, and clinical performance measures.”

Chikwe is also Irina and George Schaeffer Distinguished Chair in Cardiac Surgery in honor of Alfredo Trento, MD.

Results of additional industry studies and an NIH-funded trial comparing TEER to mitral surgery should be published within the next two years and may result in updated guidelines on the use of TEER to treat degenerative mitral regurgitation.

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