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Updated: Aug 16, 2025
08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
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Early Outcomes of 2 Mitral Valve Transcatheter Leaflet Approximation Devices: A Propensity Score-Matched Multicenter
Victor Mauri1, Atsushi Sugiura2, Max Spieker3
1Department of Cardiology, Heart Center, Faculty of Medicine, University of Cologne, Cologne, Germany.
JACC. Cardiovascular Interventions
|December 21, 2022
Summary
The PASCAL and MitraClip systems for transcatheter mitral valve repair show similar safety and efficacy. PASCAL demonstrated better reduction in mitral regurgitation and lower transmitral gradients, suggesting potential long-term benefits.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Severe mitral regurgitation (MR) can be treated with transcatheter repair systems.
- The MitraClip and PASCAL systems are approved for percutaneous mitral valve repair.
- Comparative data between these two systems are limited.
Purpose of the Study:
- To compare the procedural and short-term safety and efficacy of the PASCAL and MitraClip transcatheter mitral valve repair systems.
- To evaluate outcomes in a propensity score-matched cohort of patients undergoing repair for severe MR.
Main Methods:
- A propensity score-matched analysis of 307 patients treated with PASCAL and 307 with MitraClip.
- Matching criteria included demographic, clinical, and echocardiographic parameters.
- Primary endpoints were technical success, degree of residual MR, and major adverse events (MAE) at 30 days.
Main Results:
- Technical success rates were high and comparable (PASCAL 97.0% vs. MitraClip 98.0%).
- MR ≤2+ at discharge was similar, but MR ≤1+ was more frequent with PASCAL (70.5% vs. 56.6%).
- The PASCAL group had a significantly lower postprocedural mean transmitral gradient (P < 0.001). 30-day mortality and MAE rates were similar between groups.
Conclusions:
- Procedural success and 30-day safety outcomes were comparable between the PASCAL and MitraClip systems.
- The PASCAL system showed a trend towards better MR reduction and a significantly lower transmitral gradient.
- These procedural advantages with PASCAL may influence long-term patient outcomes.
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