Stuck in the Traffic-Light: Moving Past Color Signals to Real Decisions in Mitral Transcatheter Edge-to-Edge Therapy Management
- 1Address correspondence to: Vratika Agarwal, MD, Knight Cardiovascular Institute, Oregon Health & Sciences University, 3161 SW Pavillion Loop, Portland, OR.
- 2Division of Cardiovascular Medicine, Knight Cardiovascular Institute, Oregon Health & Sciences University, Portland, Oregon, USA
Abstract
Historically, the complexity of patients being evaluated for mitral transcatheter edge-to-edge therapy (M-TEER) has been divided into 3 main categories: green zone: defined as cases where M-TEER is straightforward and not complex, yellow zone: cases with medium complexity where M-TEER is feasible but not entirely straightforward, and red zone: cases where you would not consider M-TEER as the first option and may be swayed toward consideration of other options like transcatheter mitral valve (MV) replacement or surgical management. However, the advancement in preprocedural planning with precise anatomical definition by 3-dimensional imaging modalities has changed how we address complex mitral regurgitation cases. The expansion of available devices for management of MV disease has changed the way we think about undertaking challenging M-TEER procedures. Management in the current era emphasizes meticulous preprocedural assessment of mitral regurgitation pathology, strategic planning for device implantation, judicious device choice, and early consideration of transcatheter MV replacement or other innovative transcatheter devices. This review article provides a comprehensive overview of the available data on M-TEER and outlines treatment strategies for complex cases within the context of contemporary transcatheter technologies.
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BibTeX
@article{vratikaagarwal2026stuck,
title = {{Stuck in the Traffic-Light: Moving Past Color Signals to Real Decisions in Mitral Transcatheter Edge-to-Edge Therapy Management}},
author = {Vratika Agarwal, MD and Firas Zahr, MD},
journal = {Structural Heart},
year = {2026},
month = jul,
doi = {10.1016/j.shj.2026.101093},
url = {https://doi.org/10.1016/j.shj.2026.101093},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Stuck in the Traffic-Light: Moving Past Color Signals to Real Decisions in Mitral Transcatheter Edge-to-Edge Therapy Management
AU - Vratika Agarwal, MD
AU - Firas Zahr, MD
PY - 2026
DA - 2026/07/17
JO - Structural Heart
DO - 10.1016/j.shj.2026.101093
UR - https://doi.org/10.1016/j.shj.2026.101093
AB - Historically, the complexity of patients being evaluated for mitral transcatheter edge-to-edge therapy (M-TEER) has been divided into 3 main categories: green zone: defined as cases where M-TEER is straightforward and not complex, yellow zone: cases with medium complexity where M-TEER is feasible but not entirely straightforward, and red zone: cases where you would not consider M-TEER as the first option and may be swayed toward consideration of other options like transcatheter mitral valve (MV) replacement or surgical management. However, the advancement in preprocedural planning with precise anatomical definition by 3-dimensional imaging modalities has changed how we address complex mitral regurgitation cases. The expansion of available devices for management of MV disease has changed the way we think about undertaking challenging M-TEER procedures. Management in the current era emphasizes meticulous preprocedural assessment of mitral regurgitation pathology, strategic planning for device implantation, judicious device choice, and early consideration of transcatheter MV replacement or other innovative transcatheter devices. This review article provides a comprehensive overview of the available data on M-TEER and outlines treatment strategies for complex cases within the context of contemporary transcatheter technologies.
SN - 2474-8706
SN - 2474-8714
ER -