Through a vein in the groin, a small clip grasps the leaflets of a leaking valve and holds them together. Transcatheter edge-to-edge repair of the mitral and tricuspid valves is changing the lives of patients once told nothing could be done. In this masterclass Dr. A M Thirugnanam, author of "Transcatheter Edge-to-Edge Repair of the Mitral and Tricuspid Valves", covers: primary versus secondary (ventricular and atrial) mitral regurgitation; comprehensive and 3D severity assessment; M-TEER for primary MR in high-risk patients (EVEREST II); the secondary MR evidence — COAPT, MITRA-FR, proportionate versus disproportionate MR, RESHAPE-HF2, and the 2025 ESC/EACTS class I recommendation; optimising GDMT and CRT first; atrial secondary MR; anatomical suitability (valve area, gradient, leaflet length, calcification, flail gap and width); pre-procedure work-up; MitraClip and PASCAL; step-by-step M-TEER — transseptal height and position, steering, alignment, grasping, leaflet insertion, residual MR, gradient and v-wave; TEER in acute post-MI MR with shock; tricuspid regurgitation — causes, lead-related TR, massive and torrential grades, late presentation; T-TEER evidence (TRILUMINATE Pivotal, Tri.fr, 2025 ESC class IIa) and transcatheter replacement (TRISCEND II); T-TEER selection, imaging with transgastric views and ICE, and technique; complications — single leaflet device attachment, leaflet tear, mitral stenosis, chordal entanglement, tamponade, air embolism, iatrogenic ASD, lead dislodgement and RV afterload; post-procedure care, durability, very elderly patients, options after failed TEER, building a TEER programme, and counselling. Cases: a COAPT-like ischaemic cardiomyopathy patient treated with two clips, an elderly woman with massive lead-associated TR treated with T-TEER, and a single leaflet device attachment rescued with a second device.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D., Senior Interventional Cardiologist, author, educator and founder of the Academy of Elite Doctors.
Host: Alexander Wood
Cardiology Course FM is the station for doctors, students, nurses and everyone who looks after the heart.
Learn more:
• Cardiology books for doctors — Transcatheter Edge-to-Edge Repair of the Mitral and Tricuspid Valves, Transcatheter Aortic Valve Replacement: Tricks and Tips, Interventional Cardiology Essentials and board review, with instant e-book downloads: https://cardiologybooks.com
• Mentorship with the Academy of Elite Doctors: https://academyofelitedoctors.com
• Online cardiology courses: https://cardiologycourse.com
• World Elite Doctors: https://worldelitedoctors.com
For medical education only. This episode is not a substitute for individual medical advice.
