Key result
PASCAL TEER achieves ~100% procedural success with zero in-hospital deaths in severe mitral regurgitation.
Why the study?
Real-world experience with the PASCAL transcatheter edge-to-edge repair system for severe mitral regurgitation remains limited.
Does PASCAL-based transcatheter edge-to-edge repair (TEER) safely achieve procedural success and improve echocardiographic parameters in high-surgical-risk patients with severe mitral regurgitation?
Observational (n=23)
No
Does PASCAL-based transcatheter edge-to-edge repair (TEER) safely achieve procedural success and improve echocardiographic parameters in high-surgical-risk patients with severe mitral regurgitation?
In this early Turkish case series, the PASCAL transcatheter edge-to-edge repair system proved technically feasible and safe, achieving procedural success in 100% of high-risk patients with severe mitral regurgitation.
Background: The PASCAL transcatheter edge-to-edge repair (TEER) system was developed for patients with symptomatic severe mitral regurgitation (MR), particularly those at high surgical risk.However, real-world experience with this system remains limited.Aim: To report procedural success, in-hospital events, and discharge echocardiographic findings from the first Turkish case series of patients treated with the PASCAL system. Study Design: Retrospective study.Methods: We retrospectively reviewed consecutive patients who underwent PASCAL-based TEER at a tertiary care center between January 2023 and October 2025.Clinical, procedural, and echocardiographic data were analyzed.Results: Twenty-three patients underwent PASCAL-based TEER, with 35 devices implanted (11 P10 and 24 advanced closure and enhancement).Procedural success was achieved in all patients according to the prespecified definition.The patient with single-leaflet device attachment had residual MR ≤2+ at discharge and did not require urgent surgery; therefore, the procedure met the predefined success criteria.Two periprocedural complications occurred: one case of single-leaflet device attachment and one episode of decompensated heart failure.No in-hospital deaths occurred.Procedure duration was longer in patients with fibrotic or lipomatous interatrial septal morphology than in those with a normal interatrial septum (118 vs. 53 minutes; p=0.001).Postprocedural pulmonary venous S>D flow was observed in 21 patients (91%).The mitral valve area decreased from 5.13 cm² to 3.70 cm², and the three-dimensional vena contracta area decreased from 0.63 to 0.18 cm² (both p<0.001).Transmitral gradients increased modestly without clinically significant mitral stenosis. Conclusion:In this small retrospective series, PASCAL-based TEER was technically feasible and was associated with favorable discharge echocardiographic findings.No in-hospital deaths occurred.These findings are preliminary and should be interpreted with caution.
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Özyılmaz et al. (2026) conducted an observational in Symptomatic severe mitral regurgitation (n=23). PASCAL transcatheter edge-to-edge repair (TEER) was evaluated on Procedural success (successful PASCAL implantation with residual MR ≤2+ at discharge and no in-hospital death or urgent cardiac surgery). In a small cohort of high-risk patients with severe mitral regurgitation, PASCAL-based TEER achieved 100% procedural success with no in-hospital deaths or urgent cardiac surgeries.
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