TCT-220 Real-world Utilization of PASCAL Precision System in non-A2P2 Degenerative Mitral Regurgitation
Recommended Citation
Ramanathan P, Makkar R, Waggoner T, Latib A, Kipperman R, Hanson I, Sinha A, Chakravarty T, Sharma R, Depta J, Castellanos J, Kodali S, Krishnaswamy A, Whisenant B, Menees D, Lim S, Gilani F, Sanchez C, Gheewala N, Garcia S, Gada H, Kapadia S, Shah P, Renard B, Theodos G, Yaryura R, Gardner B, Steinberg D, Gnall E, Kaddissi G, Chhatriwalla A, Frangieh AH. TCT-220 Real-world Utilization of PASCAL Precision System in non-A2P2 Degenerative Mitral Regurgitation. J Am Coll Cardiol 2025; 86(17):B97.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Abstract
Background: Mitral valve transcatheter edge-to-edge repair (M-TEER) has historically been considered more challenging in the commissural regions of the mitral valve (A1P1, A3P3) compared to central regions (A2P2). Data on outcomes with contemporary M-TEER by implant location are limited. Methods: Degenerative mitral regurgitation (DMR) patients treated with the PASCAL Precision system between Sep 2022-Oct 2024 using a single PASCAL or PASCAL Ace implant were analyzed by device location (A2P2 vs non-A2P2) from the STS/ACC TVT Registry. Procedural, clinical, and echocardiographic outcomes to 30 days were assessed. All outcomes were site-reported. Results: The study comprised 1207 patients categorized into two groups: patients with a single implant at A2P2 (n=977) and those with a single implant at non-A2P2 position (n=230). Patients in the A2P2 group were younger, majority female, had lower incidence of flail leaflet, and a higher incidence of heart failure hospitalization (HFH) and leaflet calcification. There were no aborted procedures in either group, and successful device implantation was achieved in a high proportion of patients, 98.2% in the A2P2 group vs. 97.0% in the non-A2P2 group (P=0.299). Procedure duration was shorter in the A2P2 group (77.0 min) vs. non-A2P2 group (86.0 min) (P=0.053). The PASCAL Ace implant was used more frequently in the non-A2P2 group (87.4%) compared to A2P2 group (67.0%) (P<0.001). At 30 days, the incidence of adverse events was low and comparable in both the A2P2 and non-A2P2 groups [mortality: 1.9% vs. 2.6%; mitral valve reintervention: 0.3% vs. 0%; HFH: 1.6% vs. 3.0%; single leaflet device attachment (SLDA): 0.1% vs. 0.4%; all P>0.05]. MR reduction at 30 days was similar in the A2P2 vs non-A2P2 groups (P=0.997) with MR≤2+ and MR≤1+ rates of 94.9% vs. 95.8% and 72.0% vs. 74.3%, respectively. Conclusion: In a real-world setting, DMR patients treated with the PASCAL Precision system in both commissural and non-commissural implant locations experienced high survival, significant MR reduction and low incidence of adverse events, including SLDA, HFH and mitral valve reintervention at 30 days. Categories: STRUCTURAL: Valvular Disease and Intervention: Mitral
Volume
86
Issue
17
First Page
B97
