Related Experiment Video
Updated: Jun 18, 2026
08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Early Outcomes Between the Two Latest Generation Mitral Valve Transcatheter Edge-to-Edge Repair Devices: OCEAN-Mitral
Yusuke Enta1, Masanori Yamamoto2,3,4, Hirofumi Hioki5
1Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan.
Summary
The PASCAL device demonstrated comparable early clinical outcomes to the MitraClip system for treating primary mitral regurgitation. Both mitral valve transcatheter edge-to-edge repair (M-TEER) devices showed similar success rates, with PASCAL potentially offering a low single leaflet device attachment incidence.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Devices
Background:
- The PASCAL (Edwards Lifesciences) device for mitral valve transcatheter edge-to-edge repair (M-TEER) is a novel technology for primary mitral regurgitation (PMR).
- Comparing the latest-generation M-TEER systems, PASCAL and MitraClip (Abbott Vascular), is crucial for clinical decision-making.
Purpose of the Study:
- To compare the early clinical outcomes and procedural safety of the PASCAL M-TEER system against the MitraClip system in patients with PMR.
- To evaluate the efficacy of PASCAL in reducing mitral regurgitation (MR) severity.
Main Methods:
- A retrospective analysis of 150 patients treated with PASCAL from the Japanese OCEAN-Mitral registry.
- Comparison with a historical cohort of 679 patients treated with MitraClip for PMR.
- Propensity score (PS)-matching was employed to ensure balanced baseline characteristics between the PASCAL and MitraClip groups.
Main Results:
- The PASCAL group experienced one case of 30-day non-cardiac mortality and no deployment failures or additional surgeries.
- A single leaflet device attachment (SLDA) event occurred but was successfully retrieved, resulting in no final SLDA cases.
- Post-PS matching, both devices achieved comparable rates of MR grade ≤2+ (92.3% vs. 92.1%) and MR ≤1+ (71.6% vs. 65.8%) at 30 days.
- Device success (95.0% vs. 92.1%) and clinical success (93.5% vs. 87.8%) rates were similar between the PASCAL and MitraClip groups.
Conclusions:
- This study indicates no significant differences in early clinical outcomes between the latest-generation PASCAL and MitraClip devices for M-TEER in PMR.
- The PASCAL system's unique design may contribute to a low incidence of SLDA.
- PASCAL presents a viable alternative treatment option for patients with primary mitral regurgitation.
Related Concept Videos
01:25Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
01:22Mitral Valve Prolapse II: Assessment and Management
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
01:22Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...