Key result
Clover-like TEER with two PASCAL Ace devices successfully reduces severe MR to mild-to-moderate severity.
Case Report (n=1)
No
A clover-like multidevice transcatheter edge-to-edge repair strategy can effectively reduce severe mitral regurgitation and improve hemodynamics in patients with complex posterior mitral leaflet cleft anatomy.
Case supports PASCAL Ace feasibility in cleft-related MR; leaves open need for prospective validation.
A 75-year-old man presented with acute decompensated heart failure due to severe mitral regurgitation caused by central malcoaptation associated with a deep posterior mitral leaflet cleft and a tri-leaflet-like mitral valve configuration. Because of high surgical risk and frailty, transcatheter edge-to-edge repair was performed using the PASCAL Ace system. Initial direct approximation across the cleft caused leaflet distortion and residual mitral regurgitation between A2 and the lateral posterior mitral leaflet. A second device was therefore placed laterally, resulting in a clover-like configuration, reduced mitral regurgitation, and improved left atrial pressure.
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Omiya et al. (2026) conducted a case report in Severe mitral regurgitation (n=1). Transcatheter edge-to-edge repair using PASCAL Ace system was evaluated on Mitral regurgitation severity and left atrial pressure. Transcatheter edge-to-edge repair using two PASCAL Ace devices in a clover-like configuration successfully reduced severe mitral regurgitation to mild-to-moderate severity.
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