Acute anatomic and hemodynamic impact of mitral TEER: G4 MitraClip vs. PASCAL

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Transcatheter mitral edge-to-edge repair (TEER) represents a safe and effective alternative to surgery for high-risk patients suffering from symptomatic severe regurgitation (MR). New devices new device iterations are constantly developed their impact on the valve (MV) anatomy should be regularly evaluated provide best patient-tailored approach in future. Purpose The purpose this study was compare acute anatomic hemodynamic effects worldwide most implanted commercially available TEER devices: Abbott G4 MitraClip (MC) vs. Edwards PASCAL. Methods Consecutive our registry treated by were included. High quality volume datasets focused MV acquired during each intervention. Mean transvalvular gradient (Gd) corrected heart rate (HR), 3D area (MVA) anteroposterior diameter (AP) annulus before after implantation device; remaining orifices created measured independently summed. Results Eighty included analysis; majority with "bulky" first PASCAL P10 (10mm wide) or MC NTW/XTW (6mm wide). Individuals exhibited higher MVA clipping, however there no differences AP between both groups. produced significantly reduction group, while difference seen second implant. AP-diameter (i.e., indirect annuloplasty) Gd one two not different groups despite smaller native population. Conclusion design an active closure passive (possibly leading lower tension leaflets) could explain latter MVA, wider arms P10. A including number is needed confirm these findings, which may affect patient selection according treatment strategy.