Safety of multiple grasping attempts during transcatheter mitral valve repair with the PASCAL system.
📚 期刊: International journal of cardiology📅 发表: 0000-00-00🔬 PMID: 42314845🔗 DOI:10.1016/j.ijcard.2026.134636👁️ 浏览: 11
👤 作者: Jürgens F, Schindhelm F, Abusharekh M, Brandts CMK, Kampf J, Totzeck M, Al-Rashid F, Lüdike P, Rassaf T, Mahabadi AA
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Jürgens F, Schindhelm F, Abusharekh M, Brandts CMK, Kampf J, Totzeck M, Al-Rashid F, Lüdike P, Rassaf T, Mahabadi AA (0000). Safety of multiple grasping attempts during transcatheter mitral valve repair with the PASCAL system.. International journal of cardiology. https://doi.org/10.1016/j.ijcard.2026.134636
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📝 摘要
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.