Mitral regurgitation
Treatment options in Shanghai

A repair aims to improve closure while retaining the person's valve. Surgical repair and transcatheter edge-to-edge repair, or TEER, are not interchangeable names. TEER uses a catheter to bring parts of the leaflets together; surgical repair can address different structural abnormalities. Ask what the proposed repair would correct and whether the team expects a durable result in your anatomy. If repair might prove unsuitable during surgery, discuss the alternative beforehand. The value of keeping the valve needs to be considered alongside the likelihood of persistent leakage or a future intervention, not treated as an unconditional goal.

Replacement introduces a prosthetic valve, so the discussion continues beyond the operation. Mechanical and tissue valves have different demands. A mechanical valve generally requires lifelong anticoagulant treatment, with monitoring and bleeding considerations. A tissue valve raises different questions about durability and future procedures; it does not mean that all medicines or follow-up disappear. Ask about the actual proposed valve, your other conditions and who would manage treatment at home. A leaflet's average lifespan or another patient's experience cannot determine your own future, and a newer device is not automatically the better choice.

The 2025 ESC guidance distinguishes primary disease from selected forms of secondary regurgitation. For certain patients with heart failure and severe ventricular secondary regurgitation, TEER is considered after appropriate medical treatment and, when indicated, resynchronisation have been optimised. This is a reason to review the medication and device history, not to stop treatment while seeking a procedure. Ask why a catheter approach, surgery or continued medical management fits your case.