Mauri, Victor, Besler, Christian, Riebisch, Matthias, Al-Hammadi, Osamah, Ruf, Tobias, Gercek, Muhammed, Horn, Patrick, Grothusen, Christina, Mehr, Michael, Becher, Marc Ulrich, Mues, Christoph, Boeder, Niklas, Kreidel, Felix, Friedrichs, Kai, Westenfeld, Ralf, Braun, Daniel, Oeztuerk, Can, Baldus, Stephan, Rassaf, Tienush, Thiele, Holger, Nickenig, Georg, Hausleiter, Joerg, Moellmann, Helge, Kelm, Malte, Rudolph, Volker, von Bardeleben, Ralph-Stephan, Nef, Holger M., Luedike, Peter, Lurz, Philipp and Pfister, Roman (2020). German Multicenter Experience With a New Leaflet-Based Transcatheter Mitral Valve Repair System for Mitral Regurgitation. JACC-Cardiovasc. Interv., 13 (23). S. 2769 - 2779. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1876-7605

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Abstract

OBJECTIVES 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. BACKGROUND 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. METHODS 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). RESULTS 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 < 0.001). Rates of device success and CLASP (Edwards PASCAL Transcatheter Mitral Valve Repair System Study) trial-defined clinical success were 81.9% and 86.9%, respectively. Single-leaflet device attachment occurred in 7 patients (2.3%). CONCLUSIONS Mitral valve repair with the PASCAL system in the early post-approval phase was effective and safe, with high procedural success rates and low rates of MAE. MR was significantly reduced, accompanied by significant improvement in functional status. (C) 2020 by the American College of Cardiology Foundation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Mauri, VictorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Besler, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riebisch, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Al-Hammadi, OsamahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruf, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gercek, MuhammedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horn, PatrickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grothusen, ChristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mehr, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Becher, Marc UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mues, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boeder, NiklasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kreidel, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Friedrichs, KaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Westenfeld, RalfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braun, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oeztuerk, CanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baldus, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rassaf, TienushUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thiele, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nickenig, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hausleiter, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moellmann, HelgeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kelm, MalteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rudolph, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Bardeleben, Ralph-StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nef, Holger M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luedike, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lurz, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfister, RomanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-308127
DOI: 10.1016/j.jcin.2020.08.025
Journal or Publication Title: JACC-Cardiovasc. Interv.
Volume: 13
Number: 23
Page Range: S. 2769 - 2779
Date: 2020
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1876-7605
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/30812

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