Journal of Clinical Medicine (Jul 2024)
Early Outcomes of Two Large Mitral Valve Transcatheter Edge-to-Edge Repair Devices—A Propensity Score Matched Multicenter Comparison
- Philipp von Stein,
- Hendrik Wienemann,
- Jennifer von Stein,
- Atsushi Sugiura,
- Tetsu Tanaka,
- Refik Kavsur,
- Can Öztürk,
- Marcel Weber,
- Jean Marc Haurand,
- Patrick Horn,
- Tobias Kister,
- Amir Abbas Mahabadi,
- Niklas Boeder,
- Tobias Ruf,
- Muhammed Gerçek,
- Christoph Mues,
- Christina Grothusen,
- Julia Novotny,
- Ludwig Weckbach,
- Henning Guthoff,
- Felix Rudolph,
- Amin Polzin,
- Stephan Baldus,
- Tienush Rassaf,
- Holger Thiele,
- Helge Möllmann,
- Malte Kelm,
- Volker Rudolph,
- Ralph Stephan von Bardeleben,
- Holger Nef,
- Peter Luedike,
- Philipp Lurz,
- Jörg Hausleiter,
- Roman Pfister,
- Victor Mauri
Affiliations
- Philipp von Stein
- Department of Cardiology, Heart Center, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- Hendrik Wienemann
- Department of Cardiology, Heart Center, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- Jennifer von Stein
- Department of Cardiology, Heart Center, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- Atsushi Sugiura
- Department of Internal Medicine II, Heart Center Bonn, University Hospital Bonn, 53127 Bonn, Germany
- Tetsu Tanaka
- Department of Internal Medicine II, Heart Center Bonn, University Hospital Bonn, 53127 Bonn, Germany
- Refik Kavsur
- Department of Internal Medicine II, Heart Center Bonn, University Hospital Bonn, 53127 Bonn, Germany
- Can Öztürk
- Department of Internal Medicine II, Heart Center Bonn, University Hospital Bonn, 53127 Bonn, Germany
- Marcel Weber
- Department of Internal Medicine II, Heart Center Bonn, University Hospital Bonn, 53127 Bonn, Germany
- Jean Marc Haurand
- Department of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
- Patrick Horn
- Department of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
- Tobias Kister
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, 04289 Leipzig, Germany
- Amir Abbas Mahabadi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, 45122 Essen, Germany
- Niklas Boeder
- Department of Cardiology and Angiology, Justus-Liebig-University Giessen, 35392 Giessen, Germany
- Tobias Ruf
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Muhammed Gerçek
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany
- Christoph Mues
- Medical Clinic I, Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
- Christina Grothusen
- Medical Clinic I, Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
- Julia Novotny
- Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
- Ludwig Weckbach
- Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
- Henning Guthoff
- Department of Cardiology, Heart Center, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- Felix Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany
- Amin Polzin
- Department of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
- Stephan Baldus
- Department of Cardiology, Heart Center, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, 45122 Essen, Germany
- Holger Thiele
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, 04289 Leipzig, Germany
- Helge Möllmann
- Medical Clinic I, Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
- Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
- Volker Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany
- Ralph Stephan von Bardeleben
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Holger Nef
- Department of Cardiology and Angiology, Justus-Liebig-University Giessen, 35392 Giessen, Germany
- Peter Luedike
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, 45122 Essen, Germany
- Philipp Lurz
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, 04289 Leipzig, Germany
- Jörg Hausleiter
- Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
- Roman Pfister
- Department of Cardiology, Heart Center, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- Victor Mauri
- Department of Cardiology, Heart Center, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
- DOI
- https://doi.org/10.3390/jcm13144187
- Journal volume & issue
-
Vol. 13,
no. 14
p. 4187
Abstract
Background/Objectives: Previous trials reported comparable results with PASCAL and earlier MitraClip generations. Limited comparative data exist for more contemporary MitraClip generations, particularly the large MitraClip XT(R/W). We aimed to evaluate acute and 30-day outcomes in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) with one of the large devices, either PASCAL P10 or MitraClip XT(R/W) (3rd/4th generation). Methods: A total of 309 PASCAL-treated patients were matched by propensity score to 253 MitraClip-treated patients, resulting in 200 adequately balanced pairs. Procedural, clinical, and echocardiographic outcomes were collected for up to 30 days, including subgroup analysis for mitral regurgitation (MR) etiologies. Results: PASCAL and MitraClip patients were comparable regarding age (80 vs. 79 years), sex (female: 45.5% vs. 50.5%), and MR etiology (degenerative MR: n = 94, functional MR [FMR]: n = 96, mixed MR: n = 10 in each group). Technical success rates were comparable (96.5% vs. 96.0%; p > 0.999). At discharge, the mean gradient was higher (3.3 mmHg vs. 3.0 mmHg; p = 0.038), and the residual mitral valve orifice area was smaller in MitraClip patients (3.0 cm2 vs. 2.3 cm2; p p = 0.132). However, reduction to MR ≤ 1+ was more frequently observed in PASCAL patients (67.7% vs. 56.6%; p = 0.029), driven by the FMR subgroup (74.0% vs. 60.0%; p = 0.046). No difference was observed in 30-day mortality (p = 0.204) or reduction in NYHA-FC to ≤II (p > 0.999). Conclusions: Both M-TEER devices exhibited high and comparable rates of technical success and MR reduction to ≤2+. PASCAL may be advantageous in achieving MR reduction to ≤1+ in patients with FMR.
Keywords