Early Outcomes of Two Large Mitral Valve Transcatheter Edge-to-Edge Repair Devices-A Propensity Score Matched Multicenter Comparison

• Published in: Journal of clinical medicine Vol. 13; no. 14; p. 4187
• Main Authors: von Stein, Philipp, Wienemann, Hendrik, von Stein, Jennifer, Sugiura, Atsushi, Tanaka, Tetsu, Kavsur, Refik, Öztürk, Can, Weber, Marcel, Haurand, Jean Marc, Horn, Patrick, Kister, Tobias, Mahabadi, Amir Abbas, Boeder, Niklas, Ruf, Tobias, Gerçek, Muhammed, Mues, Christoph, Grothusen, Christina, Novotny, Julia, Weckbach, Ludwig, Guthoff, Henning, Rudolph, Felix, Polzin, Amin, Baldus, Stephan, Rassaf, Tienush, Thiele, Holger, Möllmann, Helge, Kelm, Malte, Rudolph, Volker, von Bardeleben, Ralph Stephan, Nef, Holger, Luedike, Peter, Lurz, Philipp, Hausleiter, Jörg, Pfister, Roman, Mauri, Victor
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 17.07.2024
• Subjects: Clinical medicine; Data collection; Diabetes; Etiology; Heart; Mortality; Patients; United States > US; mitral valve transcatheter edge-to-edge repair; PASCAL; MitraClip; mitral regurgitation
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13144187

Previous trials reported comparable results with PASCAL and earlier MitraClip generations. Limited comparative data exist for more contemporary MitraClip generations, particularly the large MitraClip XT(R/W). We aimed to evaluate acute and 30-day outcomes in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) with one of the large devices, either PASCAL P10 or MitraClip XT(R/W) (3rd/4th generation). A total of 309 PASCAL-treated patients were matched by propensity score to 253 MitraClip-treated patients, resulting in 200 adequately balanced pairs. Procedural, clinical, and echocardiographic outcomes were collected for up to 30 days, including subgroup analysis for mitral regurgitation (MR) etiologies. : PASCAL and MitraClip patients were comparable regarding age (80 vs. 79 years), sex (female: 45.5% vs. 50.5%), and MR etiology (degenerative MR: n = 94, functional MR [FMR]: n = 96, mixed MR: n = 10 in each group). Technical success rates were comparable (96.5% vs. 96.0%; > 0.999). At discharge, the mean gradient was higher (3.3 mmHg vs. 3.0 mmHg; = 0.038), and the residual mitral valve orifice area was smaller in MitraClip patients (3.0 cm vs. 2.3 cm ; < 0.001). At discharge, the reduction to MR ≤ 2+ was comparable (92.4% vs. 87.8%; = 0.132). However, reduction to MR ≤ 1+ was more frequently observed in PASCAL patients (67.7% vs. 56.6%; = 0.029), driven by the FMR subgroup (74.0% vs. 60.0%; = 0.046). No difference was observed in 30-day mortality ( = 0.204) or reduction in NYHA-FC to ≤II ( > 0.999). : Both M-TEER devices exhibited high and comparable rates of technical success and MR reduction to ≤2+. PASCAL may be advantageous in achieving MR reduction to ≤1+ in patients with FMR.