Related Experiment Video
Updated: Jun 20, 2026
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Safety of multiple grasping attempts during transcatheter mitral valve repair with the PASCAL system
Florian Jürgens1, Florian Schindhelm1, Mohammed Abusharekh1
1Clinic of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Germany; West German Heart Valve Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Background:
Multiple grasping attempts are routinely required during mitral valve transcatheter-edge-to-edge repairs (M-TEER) to achieve optimal leaflet capture and minimize mitral regurgitation (MR). Whether extensive grasping adversely affects procedural outcomes remains unknown.
Aims:
We aimed to evaluate safety, procedural characteristics and durability of MR reduction in M-TEER procedures with low vs. high number of grasping attempts using the PASCAL system.
Methods:
Consecutive patients with severe MR who underwent M-TEER using the PASCAL system between 2019 and 2024 at our center were analyzed. Procedures were stratified according to grasping attempts: ≤7 (≤80th percentile, median 4 [2;5]) vs. ≥8 (>80th percentile, median 10 [9;12], max. 22). Baseline, procedural, short- and latest outcomes, were compared between groups.
Results:
Overall, 391 M-TEER procedures (mean age 77.7 ± 10.1 years, 57.5% male) were included. No single leaflet device attachment, leaflet injury or other device-related complication occurred in either group. Procedures with ≥8 attempts were longer (126 ± 47.6 min vs. 82.9 ± 43.3 min; p < 0.001) and associated with larger baseline EROA (0.48 [0.38;0.70] vs. 0.40 [0.30;0.50] cm2; p = 0.0001). Improvement in MR severity from baseline to discharge (p = 0.116) and sustainability of MR reduction at latest follow-up (median 434 [176;699] days; p = 0.082) were comparable between groups. NYHA functional class improvement (p = 0.99 at 90 days; p = 0.78 at latest follow-up) and all-cause mortality (7.3% vs. 6.5%; p = 1.00) were also similar.
Conclusion:
Multiple grasping during M-TEER using the PASCAL system is safe and results in sustained MR reduction, high procedural success and latest outcomes comparable to procedures requiring fewer attempts.
