Transapical TEER: The Future Path of Precise Clipping

  With the continuous development of minimally invasive interventional techniques for structural heart diseases, transapical transcatheter edge-to-edge repair (TA-TEER) is gradually becoming an important treatment option for elderly, high-risk, and complex mitral regurgitation patients. This procedure has a shorter path and more direct device manipulation, and is especially suitable for challenging cases such as complex valve anatomy and eccentric regurgitation direction. 

Throughout the perioperative period, ultrasound imaging—especially transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE)—plays an irreplaceable key role. From preoperative lesion assessment and surgical path planning to intraoperative real-time guidance and postoperative clipping effect evaluation, ultrasound runs through the entire process and is the "key eye" that determines the success or failure of the surgery.

High-Energy Courses × Clinical Explanations × Immersive Training

Focusing on the application of ultrasound in TA-TEER procedures, Professor Li Wei systematically explained the key elements of preoperative assessment, intraoperative guidance, and intraoperative evaluation:

• Preoperative assessment: Focusing on explaining the acquisition methods of standard, biplane, and Multiview切面, identifying the origin of MR regurgitation by combining static/dynamic images, blood flow patterns, and color 3D technology, and conducting preoperative planning and case selection based on MR classification.

• Intraoperative guidance: Analyzing the key切面 and imaging points required for guiding apical puncture and clip operation.

• Intraoperative evaluation: Real-time evaluation of the clipping effect through standard切面 to ensure accurate intraoperative judgment.

  In addition, he also comprehensively sorted out the corresponding relationship between mitral valve anatomical classification and surgical strategies, and conducted in-depth analysis combined with typical cases to enhance students' comprehensive understanding of image recognition and surgical method selection.

Professor Yang Haiping, combined with a recent high-difficulty case completed by the team, systematically demonstrated the complete process of transapical TEER from preoperative assessment, intraoperative operation to postoperative follow-up, and shared his clinical experience: this procedure is simple and flexible to operate, has a large clip capture range, and has a low risk of leaflet damage and chordae tendineae entanglement. It can achieve "one-stop" repair through a small apical incision.

The on-site communication of the course was lively. Students and lecturers conducted in-depth discussions on the identification of complex valve lesions and intraoperative ultrasound guidance strategies, fully reflecting the surgeons' high attention to "image-driven TEER surgery".

Practical Operation: Hone the Ability of "Hand-Eye Coordination"

The afternoon course focused on ultrasound simulation practical training, and the high-intensity exercises comprehensively covered:

• Acquisition of TEE standard切面

• Intraoperative guidance for clip positioning

• Prediction and response to intraoperative complications

• Real-time evaluation of clipping effect and residual regurgitation

  In the environment of real equipment and simulated cases, students operated by hand and learned immersively, further strengthening the closed-loop ability from "image judgment" to "intraoperative operation".

Graduation Empowerment: Moving Towards a New Generation of "Valve Imaging Surgeons"

At the end of the event, the organizers awarded graduation certificates to all students and took a group photo to witness this compact and fulfilling professional growth journey.

"Precise Evaluation by Intraoperative Ultrasound, True Chapter in Precise Clipping."

  Through this training camp, HanYu Medical not only promoted the clinical practice standard of domestic TEER technology, but also built a growth platform for a new generation of valve imaging surgeons. In the future, the "Yu Jun Wei Valve" series of activities will continue to go deep into many regions across the country and explore the precise era of minimally invasive valves together with surgeons!