PMID- 37473817
OWN - NLM
STAT- MEDLINE
DCOM- 20230908
LR  - 20230916
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 389
DP  - 2023 Oct 15
TI  - Clinical outcomes following tricuspid transcatheter edge-to-edge repair with 
      PASCAL: A meta-analysis.
PG  - 131194
LID - S0167-5273(23)01001-X [pii]
LID - 10.1016/j.ijcard.2023.131194 [doi]
AB  - BACKGROUND: Patients with severe tricuspid regurgitation (TR) exhibit high 
      morbidity and mortality. Tricuspid transcatheter edge-to-edge repair (T-TEER) is 
      a rapidly evolving strategy to address the unmet clinical need of severe TR 
      therapies. OBJECTIVE: Organize the current body of evidence on outcomes following 
      use of the PASCAL (Edwards Lifesciences) system for T-TEER. METHODS: For this 
      meta-analysis, we searched the MEDLINE/PubMed, Embase, and Cochrane databases for 
      keywords ["tricuspid"] and ["transcatheter" or "edge-to-edge"] and ["PASCAL" or 
      "leaflet repair" or "valve repair"] from the database inception until January 11, 
      2023. Primary outcomes of interest were procedural success, mortality, New York 
      Heart Association (NYHA) functional class, 6-min walking distance (6MWD), and TR 
      severity. RESULTS: A total of 549 patients undergoing PASCAL or PASCAL Ace T-TEER 
      were included. The mean age ranged from 71.0 to 80.3 years, with 25.0 to 63.6% 
      females. The follow-up duration ranged from 30 days to 1 year. The success rate 
      was 83.5% (409/490). There was improvement in symptoms based on NYHA 
      classification (at 1- to 6-months; NYHA >/=3 RR 0.27 [95% CI 0.19-0.39]; p < 0.001) 
      and 6MWD (at 1-month; 50.96 [95% CI 32.34-69.59]; p < 0.001) post-procedure. On 
      imaging, there was improvement in TR severity post-procedure (at 1- to 
      12-months; >/= severe TR 0.21 [95% CI 0.14-0.31]; p < 0.001), which remained 
      significant with each study removed. CONCLUSION: PASCAL for T-TEER is associated 
      with high procedural success rates along with improvements in NYHA functional 
      class, TR severity, 6MWD, and patient-reported outcomes.
CI  - Copyright (c) 2023. Published by Elsevier B.V.
FAU - Badwan, Osamah
AU  - Badwan O
AD  - Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States 
      of America.
FAU - Mirzai, Saeid
AU  - Mirzai S
AD  - Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States 
      of America.
FAU - Skoza, Warren
AU  - Skoza W
AD  - Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States 
      of America.
FAU - Hawk, Fahad
AU  - Hawk F
AD  - Division of Cardiovascular Medicine, University of South Florida College of 
      Medicine, Tampa, FL, United States of America.
FAU - Braghieri, Lorenzo
AU  - Braghieri L
AD  - Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States 
      of America.
FAU - Persits, Ian
AU  - Persits I
AD  - Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States 
      of America.
FAU - Krishnaswamy, Amar
AU  - Krishnaswamy A
AD  - Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, 
      Cleveland Clinic, Cleveland, OH, United States of America.
FAU - Puri, Rishi
AU  - Puri R
AD  - Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, 
      Cleveland Clinic, Cleveland, OH, United States of America.
FAU - Kapadia, Samir R
AU  - Kapadia SR
AD  - Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, 
      Cleveland Clinic, Cleveland, OH, United States of America. Electronic address: 
      kapadis@ccf.org.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20230718
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Female
MH  - Humans
MH  - Aged
MH  - Aged, 80 and over
MH  - Male
MH  - *Heart Valve Prosthesis Implantation/methods
MH  - Treatment Outcome
MH  - Cardiac Catheterization/methods
MH  - Time Factors
MH  - *Tricuspid Valve Insufficiency/diagnosis/surgery
MH  - Tricuspid Valve/surgery
OTO - NOTNLM
OT  - MitraClip XTR
OT  - PASCAL
OT  - Transcatheter edge-to-edge repair
OT  - Tricuspid regurgitation
EDAT- 2023/07/21 01:12
MHDA- 2023/09/08 06:43
CRDT- 2023/07/20 19:23
PHST- 2023/05/05 00:00 [received]
PHST- 2023/06/11 00:00 [revised]
PHST- 2023/07/14 00:00 [accepted]
PHST- 2023/09/08 06:43 [medline]
PHST- 2023/07/21 01:12 [pubmed]
PHST- 2023/07/20 19:23 [entrez]
AID - S0167-5273(23)01001-X [pii]
AID - 10.1016/j.ijcard.2023.131194 [doi]
PST - ppublish
SO  - Int J Cardiol. 2023 Oct 15;389:131194. doi: 10.1016/j.ijcard.2023.131194. Epub 
      2023 Jul 18.