{"id":8636,"date":"2025-09-18T00:18:13","date_gmt":"2025-09-17T21:18:13","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8636"},"modified":"2025-09-18T00:18:13","modified_gmt":"2025-09-17T21:18:13","slug":"why-patient-selection-is-critical-in-m-teer-and-other-valve-interventions","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/why-patient-selection-is-critical-in-m-teer-and-other-valve-interventions\/","title":{"rendered":"Why Patient Selection Is Critical in M-TEER and Other Valve Interventions"},"content":{"rendered":"<div>Why Patient Selection Is Critical in M-TEER and Other Valve Interventions<\/div>\n<div><\/div>\n<div>Source:<\/div>\n<div>JACC: Published 4 September 2025.<\/div>\n<div><\/div>\n<div>Key Findings :<\/div>\n<div><span> 1. Reintervention risk: Reinterventions after failed mitral TEER (M-TEER) are linked with significantly worse outcomes, including higher mortality and more heart failure readmissions.<\/span><\/div>\n<div><span> 2. Large U.S. dataset: Analysis of ~13,000 Medicare patients (2013\u20132019) showed an overall 6% reintervention rate.<\/span><\/div>\n<div><span> 3. Treatment after failed M-TEER: Roughly half of the patients who required reintervention underwent a repeat procedure, while the rest were managed surgically.<\/span><\/div>\n<div><span> 4. Survival outcomes: Long-term survival was higher after surgical reintervention (61.3% at 3 years) compared with repeat M-TEER (44.8%), even though surgery after failed TEER is technically more challenging.<\/span><\/div>\n<div><span> 5. Conclusion: Careful patient selection and procedural success from the first attempt are essential to minimize the need for reintervention and improve outcomes.<\/span><\/div>\n<div><\/div>\n<div>Other Valves<\/div>\n<div><span> \u2022 Aortic (TAVR): Redo TAVR (valve-in-valve) is generally safer and preferred over open surgery, especially in older or high-risk patients.<\/span><\/div>\n<div><span> \u2022 Tricuspid (T-TEER\/TTVR): Success depends on the device \u2014 such as a clip \u2014 firmly holding the valve leaflets so they come together and close properly, reducing regurgitation, along with preserved right-ventricular function. Poor selection leads to persistent regurgitation or early failure.<\/span><\/div>\n<div><span> \u2022 Pulmonic (TPVR): Redo TPVR is often preferred; surgery is considered mainly in complex cases.<\/span><\/div>\n<div><\/div>\n<div>Durability &amp; Complications :<\/div>\n<div><span> \u2022 Durability: TAVR valves remain effective for ~8\u201310 years; M-TEER maintains MR reduction for ~5 years in most patients; TPVR durability is ~5\u201310 years depending on device; long-term tricuspid TEER data are still limited (~1\u20132 years).<\/span><\/div>\n<div><span> \u2022 Complications: Major risks include death (1\u20134%), stroke (2\u20134%), bleeding (2\u20135%), need for pacemaker after TAVR (10\u201320%), and paravalvular leak (~5\u201315%); rates vary by valve type and patient profile.<\/span><\/div>\n<div><\/div>\n<div>Universal Principle :<\/div>\n<div>Across all transcatheter valves A Heart Team approach is vital to reduce complications and improve long-term survival.<\/div>\n<div><\/div>\n<div><a href=\"https:\/\/www.jacc.org\/doi\/10.1016\/j.jcin.2025.07.025\">https:\/\/www.jacc.org\/doi\/10.1016\/j.jcin.2025.07.025<\/a><\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Why Patient Selection Is Critical in M-TEER and Other Valve Interventions Source: JACC: Published 4 September 2025. Key Findings : 1. Reintervention risk: Reinterventions after failed mitral TEER (M-TEER) are linked with significantly worse outcomes, including higher mortality and more heart failure readmissions. 2. Large U.S. dataset: Analysis of ~13,000 Medicare patients (2013\u20132019) showed an [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8636","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8636","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8636"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8636\/revisions"}],"predecessor-version":[{"id":8637,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8636\/revisions\/8637"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8636"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8636"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8636"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}