Transcather Edge-to-Edge Repair (TEER) with MitraClip® and TriClip

Transcatheter edge-to-edge repair (TEER) is a minimally invasive heart valve procedure for patients who are not candidates for traditional open-heart surgery.

When used with Abbott’s MitraClip® and/or TriClip® technology, TEER can be used to repair leaky mitral valves and tricuspid valves.

• Mitral valve — The heart valve that regulates blood flow from the left atrium into the left ventricle.
• Tricuspid valve —The heart valve between the right ventricle and right atrium.

TEER avoids open-heart surgery and is associated with faster recovery times, improved heart function, and improved quality of life.

What Is Transcatheter Edge-to-Edge Repair?

Transcatheter edge-to-edge repair (TEER) is a minimally invasive procedure option for patients with mitral regurgitation (MR) or tricuspid regurgitation (TR).

The heart controls blood flow through four valves — the aortic, mitral, pulmonary, and tricuspid valves. Two of these valves — tricuspid and mitral — have large flaps called leaflets that open and close for blood flow. When these valves don’t close properly, some blood can flow backward, called regurgitation.

TEER at UPMC involves the use of two Abbott products — the MitraClip® for mitral valve regurgitation and the TriClip® for tricuspid valve regurgitation. Additionally, UPMC experts use the PASCAL systems by Edwards Lifesciences for some TEER procedures.

Why Do You Perform TEER?

Mitral regurgitation and tricuspid regurgitation both involve the heart’s inability to efficiently pump blood.

MR and TR can cause symptoms that can make it hard to function, including:

• Fatigue — Due to the heart's reduced efficiency in pumping blood.
• Palpitations — Irregular heartbeats or a sensation of the heart racing.
• Shortness of breath — During physical activity or even at rest.
• Swelling — Particularly in the legs, ankles, or abdomen, due to fluid buildup.

These symptoms can significantly alter a person's quality of life.

TEER is used to fix leaky mitral or tricuspid heart valves without the use of traditional open heart surgery.

This method repairs the valve instead of replacing it completely, causing less stress on the heart and minimizing the chance for infection, blood clots, and the need for blood thinners afterward.

What are the complications of TEER?

Undergoing TEER with Triclip or MitraClip may cause some complications, including:

• Clip implantation issues, such as partial detachment.
• Damage to the heart valves or leaflets.
• Ischemic events, such as heart attack and stroke.
• Renal (kidney) failure.
• Risk of injection and major bleeding.

What happens during TEER?

First, an anesthesiologist will put you under general anesthesia. You will remain under anesthesia for the duration of the procedure.

Next, a doctor will make a small incision in your groin. They then advance a thin catheter (tube) through the big vein in the leg into the left ventricle of the heart.

Using a transesophageal echocardiogram (TEE) for guidance, the doctor advances the steerable catheter containing the MitraClip or TriClip past the faulty valve.

The catheter is positioned below the valve to catch the leaflets, then clipped to grip the leaflets. This creates an opening with two smaller holes.

Using the nimble catheter system, the doctor can open and close the MitraClip or TriClip for perfect positioning. Then the device is released and retracted, leaving the MitraClip or TriClip in place.

Over time, tissue growth on the clip creates a fibrous tissue bridge, sealing the leaky leaflets.

Is TEER Right for Me?

TEER is right for patients who may not respond well to traditional open-heart surgery because the recovery time is faster and involves fewer complications.

If you have mitral regurgitation or tricuspid regurgitation and you are at intermediate- or high-risk for open heart surgery, TEER may be right for you. It’s essential to consult with your cardiologist or primary care physician to develop a personalized treatment plan.

What to Expect from TEER?

Since patients who undergo TEER are often older and sicker than patients who can tolerate open heart surgery, the goal of the procedure is not necessarily to extend longevity. Instead, the goal is to improve symptoms to restore people’s mobility and increase their quality of life.

• The TEER with MitraClip® procedure can reduce the leakiness of a severely leaky mitral valve, which can restore a person’s function and mobility.
• The TEER with TriClip® procedure can reduce the leakiness of a severely leaky tricuspid valve, which can also restore mobility and increase quality of life.

Keeping people mobile and able to live their day-to-day lives is key to moving toward healthier heart habits and preventing further symptoms.

By UPMC Editorial Staff. Last reviewed on 2025-09-09.