ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Three-dimensional mitral valve geometry after transcatheter edge-to-edge repair: PASCAL versus PASCAL-ACE-implications for devices selection.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe PASCAL® transcatheter edge-to-edge repair system (TEER) is established for mitral regurgitation (MR), with the ACE iteration tailored for complex anatomies. Comparative data are limited.
aimsTo compare 3D mitral valve remodeling and procedural outcomes in patients undergoing TEER with PASCAL or PASCAL ACE device at a high-volume tertiary center.
methodsThis retrospective, single-center study included 366 consecutive patients (mean age 77.7 ± 10.2 years; 57.9% male) with moderate-to-severe or severe MR treated between 2019 and 2024. Patients were stratified by device (ACE, n = 128, PASCAL, n = 238). Procedural outcomes and 3D echocardiographic remodeling were evaluated.
resultsACE-treated patients had more complex mitral anatomies and larger baseline mitral valve orifice areas (3D-MVOA, 6.55 [5.74-7.96] vs. 5.87 [4.86-7.38] cm
conclusionsIn this real-world cohort, the ACE device was preferentially used in more complex mitral anatomies. Post-procedural MVOA was dictated by baseline valve anatomy rather than device configuration, with comparable relative MVOA reduction, annular remodeling, and procedural success, advocating for an anatomy-guided device selection.
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