New heart valves can now be placed without open surgery, with benefits at 2 years
☕ Includes a question for the family ↓
Heart valvesPart of a story we are following · 3 articles · See every update
If you or someone you love has a leaky heart valve, there is now a way to replace it without open-heart surgery. Newer heart valves are placed through a thin tube guided to the heart, and a new study shows the fix held up for two years.
In a study of 299 people with a leaking mitral valve who were not good candidates for surgery or for a clip repair, a catheter-placed replacement valve kept the leak at a trace or none in 97.0% of the people followed for two years, and most were still doing well in daily life.
How the study worked
The ENCIRCLE trial treated 299 older adults who had a significantly leaking mitral valve and symptoms. Doctors placed a new valve through a vein in the leg and across to the heart, with no chest incision. Independent experts checked the heart images and the health events. This update reports two-year results, with follow-up data for 202 of the 210 people who were eligible. It was a single-group trial with no comparison group, and it was published in J Am Coll Cardiol on November 3, 2026.
What does the mitral valve do, and what is a leak?
The mitral valve is a one-way door inside your heart. It opens to let blood flow forward and closes to keep it from sliding back. When it leaks, blood flows backward, and the heart has to work harder. People can feel tired and short of breath.
What they found
The people in the study were 75.5 years old on average.
The leak stayed nearly gone. At two years, 97.0% of people had little to no leakage. That matters, because the leak is what causes the symptoms.
People also kept feeling better. About 87% were in the two mildest groups of the standard heart symptom scale (87.0% in NYHA class I or II), meaning they could do everyday activities with little or no trouble. A health survey that scores how heart problems affect daily life rose by 17.2 points on average, and that gain lasted.
The study also gives a plain look at what happened to people over time. Over two years, about a quarter of the people (25.1%) died from any cause, and 23.0% were hospitalized at least once for heart failure. Looking only at the second year, 13.0% died and 10.6% had a first hospital stay for heart failure. These were people with serious heart disease who were considered high risk for surgery.
Some valve-related problems did happen over the two years. Disabling stroke occurred in 6.6% of people, a clinically significant blood clot on the valve in 7.1%, and damage to red blood cells needing treatment in 7.6%. None of the people had a blockage of blood flow out of the heart’s main pumping chamber.
One measure did not move much: the distance people could walk in six minutes rose only a little on average, and that change was not clearly different from zero.
What you can do today
If you or a family member has been told that a leaky mitral valve cannot be fixed with surgery or a clip, write down one question for the next heart appointment: “Am I a candidate for a catheter-placed mitral valve, and is there a heart valve team that does this near me?” Bring a family member to help you remember the answer.
Talk about it at home
Your heart has a door called the mitral valve that swings open to let blood move forward and swings shut so it can’t slip backward. When that door doesn’t close well, the heart has to push harder, a bit like trying to fill a bucket that has a hole in it. In this study, doctors slipped a new valve to the heart through a thin tube that travels through a vein in the leg, so nobody had to open the chest.
Try it at home
Ask a grandparent or an older neighbor what they remember about how doctors fixed hearts when they were young, and whether they ever knew someone who got a new heart valve.
Keep exploring
Copies this article and its questions so you can paste them into ChatGPT, Claude, Gemini or the AI you use, and keep the conversation going.
Questions and answers
- What is a transcatheter mitral valve replacement?
- It is a way to replace a leaking mitral valve by guiding a new valve through a vein in the leg to the heart, with no chest incision.
- Who was in the ENCIRCLE trial?
- It included 299 older adults, with an average age of 75.5, who had a significantly leaking mitral valve with symptoms and were not suitable for surgery or a clip repair.
- Did the valve keep working after two years?
- Yes. At two years, 97.0% of people had little to no leakage, and improvements in daily life were sustained.
- Were there risks?
- Some problems happened over two years, including disabling stroke in 6.6% of people and valve clots in 7.1%.
