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08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
The Thromboembolic Continuum in Transcatheter Mitral Valve Repair: A Comprehensive Review
Nikolaos Manganiaris1, Kyriakos Dimitriadis1, Kyriaki Mavromoustakou1
1First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, Greece.
Journal of Clinical Medicine
|May 13, 2026
Summary
Mitral transcatheter edge-to-edge repair (M-TEER) offers a low-risk option for mitral regurgitation. Managing thromboembolic risk requires understanding pre-procedural factors, periprocedural device time, and individualized post-procedural strategies.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Technology
Background:
- Severe mitral regurgitation is managed with mitral transcatheter edge-to-edge repair (M-TEER), a less invasive alternative to surgery.
- Thromboembolic risk is a significant challenge in M-TEER, influenced by various clinical factors.
- Atrial cardiomyopathy contributes to a prothrombotic state before M-TEER procedures.
Purpose of the Study:
- To review the multifaceted thromboembolic risks associated with M-TEER.
- To identify key determinants of embolic burden across different procedural phases.
- To explore strategies for mitigating embolic events and enhancing patient safety.
Main Methods:
- Review of existing literature on M-TEER and thromboembolic complications.
- Analysis of pre-procedural, periprocedural, and post-procedural factors influencing embolic risk.
- Discussion of diagnostic tools like MRI and emerging technologies.
Main Results:
- Atrial cardiomyopathy creates a prothrombotic environment pre-M-TEER.
- Periprocedural device time is a significant predictor of embolic burden.
- Subclinical ischemic lesions are common, but overt deficits are infrequent.
- Individualized antithrombotic strategies and left atrial appendage occlusion are discussed for post-procedural management.
Conclusions:
- Mitigating M-TEER-related thromboembolic risk requires a comprehensive approach addressing all procedural phases.
- Integrating clinical insights with advanced technologies like AI and digital twins can optimize planning and safety.
- Personalized management strategies are crucial for improving outcomes in M-TEER patients.
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