German Multicenter Experience With a New Leaflet-Based Transcatheter Mitral Valve Repair System for Mitral Regurgitation

The aim of this study was to investigate the procedural and short-term safety and efficacy of a new leaflet-based transcatheter mitral valve repair system. The PASCAL repair system has been recently approved for percutaneous treatment of mitral regurgitation (MR). Novel characteristics are broad pad...

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Published in:JACC. Cardiovascular interventions 2020-12, Vol.13 (23), p.2769-2778
Main Authors: Mauri, Victor, Besler, Christian, Riebisch, Matthias, Al-Hammadi, Osamah, Ruf, Tobias, Gerçek, Muhammed, Horn, Patrick, Grothusen, Christina, Mehr, Michael, Becher, Marc Ulrich, Mues, Christoph, Boeder, Niklas, Kreidel, Felix, Friedrichs, Kai, Westenfeld, Ralf, Braun, Daniel, Öztürk, Can, Baldus, Stephan, Rassaf, Tienush, Thiele, Holger, Nickenig, Georg, Hausleiter, Jörg, Möllmann, Helge, Kelm, Malte, Rudolph, Volker, von Bardeleben, Ralph-Stephan, Nef, Holger M., Luedike, Peter, Lurz, Philipp, Pfister, Roman
Format: Article
Language:English
Subjects:
mitral regurgitation
PASCAL
transcatheter mitral valve repair
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Summary:The aim of this study was to investigate the procedural and short-term safety and efficacy of a new leaflet-based transcatheter mitral valve repair system. The PASCAL repair system has been recently approved for percutaneous treatment of mitral regurgitation (MR). Novel characteristics are broad paddles positioned around a central spacer and the ability for independent leaflet capture. Procedural and 30-day outcomes were investigated in the first 309 patients with symptomatic MR 3+/4+ treated with the PASCAL repair system at 10 sites. Primary efficacy endpoints were technical success and degree of residual MR at discharge. The primary safety endpoint was the rate of major adverse events (MAE). Among the 309 patients (mean age 77 ± 10 years, 42% women, mean European System for Cardiac Operative Risk Evaluation II score 5.8 ± 4.5%) included in this study, MR etiology was degenerative in 33%, functional in 52%, and mixed in 16%. Eighty-six percent of patients were in New York Heart Association functional class III or IV. The technical success rate was 96%. Of 308 patients discharged alive, MR was ≤2+ in 93.5%. At 30 days, the MAE rate was 4.1%, with an estimated all-cause mortality rate of 2.0%, and 72% of patients were in New York Heart Association functional class ≤II (p 
ISSN:1936-8798
1876-7605
DOI:10.1016/j.jcin.2020.08.025