Key result
Mitral TEER linked to ~37% lower left atrial pressures and improved cardiac index.
Why the study?
The extent to which hemodynamic improvements from transcatheter edge-to-edge repair translate into reverse remodeling and clinical benefit remains to be clarified.
Does mitral valve transcatheter edge-to-edge repair with the PASCAL system improve hemodynamics and reverse cardiac remodeling in patients with severe symptomatic mitral regurgitation?
Cohort (n=130)
Does mitral valve transcatheter edge-to-edge repair with the PASCAL system improve hemodynamics and reverse cardiac remodeling in patients with severe symptomatic mitral regurgitation?
Effect estimate: cardiac index +11.37%, left atrial pressures -36.97%
p-value: p=<0.01
Transcatheter edge-to-edge repair with the PASCAL system provides immediate hemodynamic improvements that translate into reverse cardiac remodeling and are associated with better mid-term clinical outcomes.
Aims Chronic mitral regurgitation causes hemodynamic and myocardial changes leading to increased left atrial volume and left ventricular preload and finally eccentric hypertrophy of the left ventricle. The extent to which mitral valve transcatheter edge-to-edge repair induced hemodynamic improvements translate into reverse remodeling and clinical benefit remains to be clarified. This project aimed to investigate periprocedural hemodynamic changes during mitral valve transcatheter edge-to-edge repair, their effects on reverse cardiac remodeling and the associated effects on heart failure-related hospitalization and all-cause mortality. Methods In this retrospective study, 130 patients with severe symptomatic mitral regurgitation underwent transcatheter edge-to-edge repair. Hemodynamic parameters were assessed pre- and immediately post-procedure, and echocardiography was performed at 6–12 months (median 188 days, IQR 26). Clinical follow-up included one-year heart failure hospitalization and all-cause mortality. Short-term hemodynamic data were available in 86 patients and long-term echocardiographic follow-up in 73, with incomplete datasets excluded from the respective analyses. Results Mitral valve transcatheter edge-to-edge repair significantly improved cardiac index (+11.37%, p<0.01) and reduced left atrial pressures (−36.97%, p<0.01). Echocardiography demonstrated reduced left ventricular end-diastolic diameter (−2.8 mm, −4.0%, p=0.004) and improved right ventricular function (RV-FAC +5.8%, p=0.019) at follow-up. Patients with improved left ventricular global longitudinal strain had lower mortality and hospitalization rates. Conclusion Mitral valve transcatheter edge-to-edge repair with the PASCAL® system is linked with immediate hemodynamic improvements that may be associated with reverse cardiac remodeling and improved mid-term clinical outcomes. Monitoring acute hemodynamic effects may help predict positive remodeling and outcome effects.
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Bladt et al. (2026) conducted a cohort in severe symptomatic mitral regurgitation (n=130). Mitral valve transcatheter edge-to-edge repair (PASCAL system) was evaluated on periprocedural hemodynamic changes (cardiac index and left atrial pressures) (cardiac index +11.37%, left atrial pressures -36.97%, p=<0.01). Mitral valve transcatheter edge-to-edge repair significantly improved cardiac index (+11.37%, p<0.01) and reduced left atrial pressures (-36.97%, p<0.01).
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