PMID- 37240685 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230530 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 10 DP - 2023 May 20 TI - Edge-to-Edge Transcatheter Mitral Valve Repair Using PASCAL vs. MitraClip: A Systematic Review and Meta-Analysis. LID - 10.3390/jcm12103579 [doi] LID - 3579 AB - BACKGROUND: Transcatheter edge-to-edge repair (TEER) of the mitral valve (MV) can be performed using the PASCAL or MitraClip devices. Few studies offer a head-to-head outcome comparison of these two devices. MATERIAL AND METHODS: PubMed, EMBASE, Cochrane Library, Clinicaltrials.gov and WHO's International Clinical Trials Registry Platform, from 1 January 2000 until 1 March 2023, were searched. Study protocol details were registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42023405400). Randomized Controlled Trials and observational studies reporting head-to-head clinical comparison of PASCAL and MitraClip devices were eligible for selection. Patients with severe functional or degenerative mitral regurgitation (MR) who had undergone TEER of the MV with either PASCAL or MitraClip devices were included in the meta-analysis. Data from six studies (five observational and one randomized clinical trial) were extracted and analyzed. The main outcomes were a reduction in MR to 2+ or less, improvement of New York Heart Association (NYHA) and 30-day all-cause mortality. Peri-procedural mortality, success rate and adverse events were also compared. RESULTS: Data from 785 and 796 patients that underwent TEER using PASCAL and MitraClip, respectively, were analyzed. Thirty-day all-cause mortality (Risk ratio [RR] = 1.51, 95% CI 0.79-2.89), MR reduction to maximum 2+ (RR = 1.00, 95% CI 0.98-1.02) and NYHA improvement (RR = 0.98, 95% CI 0.84-1.15) were similar in both device groups. Both devices had high and similar success rates (96.9% and 96.7% for the PASCAL and MitraClip group, respectively, p value = 0.91). MR reduction to 1+ or less at discharge was similar in both device groups (RR = 1.06, 95% CI 0.95-1.19). Composite peri-procedural and in-hospital mortality was 0.64% and 1.66% in the PASCAL and MitraClip groups, respectively (p value = 0.094). Rates of peri-procedural cerebrovascular accidents were 0.26% in PASCAL and 1.01% in MitraClip (p value = 0.108). CONCLUSIONS: Both PASCAL and MitraClip devices have high success and low complication rates for TEER of the MV. PASCAL was not inferior to MitraClip in reducing the MR level at discharge. FAU - Hosseini, Kaveh AU - Hosseini K AUID- ORCID: 0000-0001-5676-3099 AD - Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran. AD - Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran. FAU - Soleimani, Hamidreza AU - Soleimani H AD - Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran. AD - Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran. AD - Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran 1411713139, Iran. FAU - Nasrollahizadeh, Amir AU - Nasrollahizadeh A AUID- ORCID: 0000-0001-6328-8468 AD - Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran. AD - Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran. FAU - Jenab, Yaser AU - Jenab Y AD - Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran. AD - Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1419733141, Iran. FAU - Karlas, Angelos AU - Karlas A AD - Institute for Biological and Medical Imaging, Helmholtz Zentrum Munchen, 85764 Neuherberg, Germany. AD - Department for Vascular and Endovascular Surgery, Rechts der Isar Hospital, Technical University of Munich, 81675 Munich, Germany. FAU - Avgerinos, Dimitrios V AU - Avgerinos DV AD - Onassis Cardiac Surgery Center, 17674 Athens, Greece. FAU - Briasoulis, Alexandros AU - Briasoulis A AUID- ORCID: 0000-0002-5740-9670 AD - Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Kuno, Toshiki AU - Kuno T AD - Department of Medicine, Montefiore Medical Center, New York, NY 10461, USA. FAU - Doulamis, Ilias AU - Doulamis I AD - Department of Surgery, The Johns Hopkins Hospital, School of Medicine, Baltimore, MD 21287, USA. FAU - Kampaktsis, Polydoros N AU - Kampaktsis PN AD - Division of Cardiology, Columbia University Irving Medical Center, New York, NY 10032, USA. LA - eng PT - Journal Article PT - Review DEP - 20230520 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10219028 OTO - NOTNLM OT - MitraClip OT - PASCAL OT - mitral regurgitation OT - transcatheter edge-to-edge repair COIS- The authors declare no conflict of interest. EDAT- 2023/05/27 09:42 MHDA- 2023/05/27 09:43 PMCR- 2023/05/20 CRDT- 2023/05/27 01:18 PHST- 2023/04/19 00:00 [received] PHST- 2023/05/12 00:00 [revised] PHST- 2023/05/18 00:00 [accepted] PHST- 2023/05/27 09:43 [medline] PHST- 2023/05/27 09:42 [pubmed] PHST- 2023/05/27 01:18 [entrez] PHST- 2023/05/20 00:00 [pmc-release] AID - jcm12103579 [pii] AID - jcm-12-03579 [pii] AID - 10.3390/jcm12103579 [doi] PST - epublish SO - J Clin Med. 2023 May 20;12(10):3579. doi: 10.3390/jcm12103579.