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Help your patients start a new chapter with transcatheter edge-to-edge repair (TEER)

A growing body of evidence supports TEER for patients with clinically significant, symptomatic mitral regurgitation (MR) who are at high or prohibitive surgical risk – even in those with complex anatomies.1–3

About TEER 

Mitral TEER, also referred to as transcatheter mitral valve repair (TMVr), is a percutaneous catheter-based approach that aims to restore mitral valve leaflet coaptation, thus reducing MR.4

Exploring the TEER procedure

TEER is a minimally invasive technique that approximates the anterior and posterior mitral valve leaflets by grasping them with a clasping device.5

TEER procedure step 1

Step 1

Patient is anaesthetised or sedated. Access is gained to the right femoral vein via a transvenous transfemoral approach.

TEER procedure step 2

Step 2

A guidewire is advanced to the superior vena cava and used to position the transseptal sheath, and a needle is inserted for a conventional percutaneous transseptal puncture.

TEER procedure step 3

Step 3

The sheath and needle are advanced to the left atrium. The needle is removed, and  a guidewire for the guide catheter is advanced to the left superior pulmonary vein.

TEER procedure step 4

Step 4

The implant delivery system is advanced through the left atrium to the left ventricle using a guide catheter and introducer.

TEER procedure step 5

Step 5

The implant grasps the leaflets, and the residual MR severity and mitral valve gradient are assessed. The implant is repositioned if needed, or another implant is added.

TEER procedure step 6

Step 6

Once the optimal residual MR and gradient are achieved, the implant delivery system is removed, and the access site is closed.

Watch TEER procedural video

Sustained safety and effectiveness of the PASCAL System3

Professor Dr. med. Tobias Geisler

In 2024, 2-year data were released for the MiCLASP study, the CLASP IID trial and the CLASP IID registry.2,3 The findings are very assuring for interventional cardiologists, referring colleagues and for patients, and will hopefully contribute to increased confidence in TMVr in a broad spectrum of MR.*

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Professor Dr med. Tobias Geisler
University Hospital Tübingen, Germany 

* Expert opinions, advice and all other information expressed represent contributors' views and not necessarily those of Edwards Lifesciences.

Professor Dr. med. Tobias Geisler

Sustained safety and effectiveness of TEER at 2 years in patients with significant, symptomatic MR in a post-market setting.3

81 MR
Freedom from CV mortality

Freedom from CV mortality

Freedom from HFH

Freedom from HFH

NYHA class I/II

NYHA class I/II

KCCQ-OS

KCCQ-OS

*Baseline versus 2 years (n=228; MR ≤1+=80.7%; MR ≤2+=98.3%).

CV: cardiovascular; HFH: heart failure hospitalisation; KCCQ-OS: Kansas City Cardiomyopathy Questionnaire Overall Summary Score; NYHA: New York Heart Association.


Dr med. Dabit Arzamendi

The advantage of transcatheter techniques is that they’re minimally invasive.  You treat the disease, and it doesn’t involve a long stay in hospital.*

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Dr med. Dabit Arzamendi
Hospital Sant Pau, Barcelona, Spain

* Expert opinions, advice and all other information expressed represent contributors' views and not necessarily those of Edwards Lifesciences.

Dr med. Dabit Arzamendi

“My quality of life has increased
enormously!”

Reinhold, MR patient

TEER for degenerative MR (DMR): Sustained MR reduction and patient benefits 

TEER could be especially beneficial for patients with DMR who have been turned down for surgery due to high risk or other health concerns.6

In the CLASP IID trial, TEER has shown significant and sustained MR reduction in patients with severe, symptomatic DMR at prohibitive surgical risk at 2 years.2

MR 79%
Freedom from CV mortality

Freedom from CV mortality

Freedom from HFH

Freedom from HFH

NYHA class I/II

NYHA class I/II

KCCQ-OS

KCCQ-OS

*Data from unpaired analysis. The presented MR reduction was achieved using the PASCAL system. 
CV: cardiovascular; HFH: heart failure hospitalisation; KCCQ-OS: Kansas City Cardiomyopathy Questionnaire Overall Summary Score; MR: mitral regurgitation; NYHA: New York Heart Association. 

These 2-year outcomes extend to patients with complex mitral anatomy, who were ineligible for the CLASP IID trial but were enrolled in the CLASP IID registry.2

MR 69%
Freedom from CV mortality

Freedom from CV mortality

Freedom from HFH

Freedom from HFH

NYHA class I/II

NYHA class I/II

KCCQ-OS

KCCQ-OS

*Data from unpaired analysis. 

CV: cardiovascular; HFH: heart failure hospitalisations; KCCQ-OS: Kansas City Cardiomyopathy Questionnaire Overall Summary Score; MR: mitral regurgitation; NYHA: New York Heart Association. 

TEER for functional MR (FMR): Clinical benefits and improved quality of life 

Reduction in all-cause mortality with current therapies for HF range from approximately 15% to 40%, with the highest reduction being reported for TEER treatment.7

Lowered mortality8

TEER significantly lowers the risk of death in patients (6 patients needed to treat to prevent 1 death).

Reduced HFH visits8

TEER was better at reducing HFH visits than guideline-directed medical therapy (GMDT), with only 3 people needing treatment to prevent 1 hospital stay.

Lower of occurrence of adverse events at 1 year

Lower occurrence of major adverse events at 1 year10

Improved KCCQ Score at 1 year

Improved KCCQ score at 1 year9*

*p<0.001 

GDMT: guideline-directed medical therapy; KCCQ-OS: Kansas City Cardiomyopathy Questionnaire Overall Summary Score; TEER: transcatheter-edge-to-edge repair. 

Jaume, MR patient inside heart

When I could get back to playing the sports I had given up, it gives me incredible satisfaction.

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Jaume, MR patient

See Jaume's story
Jaume, MR patient inside heart

Help your patients start a new chapter

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grey heart

References

  1. Spargias K, Lim DS, Makkar R, et al. Three-year outcomes for transcatheter repair in patients with mitral regurgitation from the CLASP study. Catheter Cardiovasc Interv. 2023;102(1):145–154. doi:10.1002/ccd.30686.
  2. Makkar R. CLASP IID randomised trial and registry: Two-year outcomes of transcatheter edge-to-edge repair for degenerative mitral regurgitation. PCR London Valves; 24–26 November 2024, London, UK.
  3. Geisler T. Two-year outcomes of mitral transcatheter edge-to-edge repair from the MiCLASP study. presented at: PCR London Valves; 24–26 November 2024, London, UK.
  4. Yazdchi F, Tang GHL, Nguyen TC, Kaneko T. Transcatheter edge to edge mitral valve repair (MitraClip) step by step guide. Operative Techniques in Thoracic and Cardiovascular Surgery. 2022;27(2):177–197. doi:10.1053/j.optechstcvs.2021.12.007.
  5. Centers for Medicare & Medicaid Services. Transcatheter Edge-to-Edge Repair (TEER). Accessed 13 March 2025, https://www.cms.gov/medicare/coverage/evidence/edge-to-edge-repair-teer
  6. Blackman DJ, Schlosshan D, Dawkins S, Smith R, Byrne J, MacCarthy PA. Mitral valve TEER in the UK: What you need to know as TEER becomes routinely available in the NHS. Br J Cardiol. 2023;30(4):34. doi:10.5837/bjc.2023.034.
  7. Goel K, Barker CM, Lindenfeld J. Contemporary management of secondary mitral regurgitation. European Cardiology Review. 2020;15:e22. doi:10.15420/ecr.2019.08.
  8. Tachibana RH, Bainbridge D. 5-Year results of the COAPT trial: What did we learn? J Cardiothorac Vasc Anesth. 2023;37(12):2423–2424. doi:10.1053/j.jvca.2023.08.003.
  9. Anker SD, Friede T, von Bardeleben RS, et al. Transcatheter valve repair in heart failure with moderate to severe mitral regurgitation. N Engl J Med. 2024;391(19):1799–1809. doi:10.1056/NEJMoa2314328.
  10. Baldus S, Doenst T, Pfister R, et al. Transcatheter repair versus mitral-valve surgery for secondary mitral regurgitation. N Engl J Med. 2024;391(19):1787–1798. doi:10.1056/NEJMoa2408739.
Medical device for professional use.

Medical device for professional use.

For a listing of indications, contraindications, precautions, warnings, and potential adverse events, please refer to the Instructions for Use (consult eifu.edwards.com where applicable).