PASCAL versus MitraClip-XTR edge-to-edge device for the treatment of tricuspid regurgitation: a propensity-matched analysis

• DOI: 10.1007/s00392-020-01784-w
• Publication Date: 2020-12-12T16:02:22Z
• Authors: Atsushi Sugiura; Johanna Vogelhuber; Can Öztürk; Zita Schwaibold; David Reckers; Tadahiro Goto; Refik Kavsur; Marc Ulrich Becher; Sebastian Zimmer; Georg Nickenig; Marcel Weber
• Keywords: MitraClip; Interquartile range; Clinical endpoint; Pascal (unit)

Abstract Background Transcatheter tricuspid valve repair (TTVR) is a promising technique for the treatment of regurgitation (TR). Data comparing performance novel edge-to-edge devices (PASCAL and MitraClip-XTR) are scarce. Methods We identified 80 consecutive patients who underwent TTVR using either PASCAL or MitraClip-XTR system to treat symptomatic TR from July 2018 June 2020. To adjust baseline imbalances, we performed propensity score (PS) 1:1 matching. The primary endpoint was reduction in severity by at least one grade 30 days. Results PS-matched cohort ( n = 44) high-surgical risk (EuroSCORE II: 7.5% [interquartile range (IQR) 4.8–12.1%]) with mean 4.3 ± 0.8 median coaptation gap 6.2 mm [IQR 3.2–9.1 mm]. similarly observed both groups (PASCAL: 91% vs. MitraClip-XTR: 96%). Multiple device implantation most common form (59% 82%, p 0.19), occurrence SLDA comparable between (5.7% [2 35 implanted devices] 4.4% 45 devices], 0.99). No periprocedural death conversions surgery occurred, 30-day mortality (5.0% 5.0%, log-rank 0.99) 3-month (10.0% 0.56) were similar groups. During follow-up, functional NYHA class, 6-min walking distance, health status improved Conclusions Both devices, MitraClip-XTR, appeared feasible an effective reduction. Randomized head-to-head comparisons will help further define appropriate scope application each system.