Most mitral regurgitation patients treated with TEER will require surgery if treatment fails

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." said Dr. Joanna Chikwe, chair of the Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai and the Irina and George Schaeffer Distinguished Chair in Cardiac Surgery in honor of Alfredo Trento, MD. "These findings should inform patient consent for TEER, design of clinical trials, and clinical performance measures."

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.