Background: Transcatheter edge-to-edge mitral valve repair (MV-TEER) reduces mitral valve orifice areas in patients with degenerative (DMR) and functional (FMR) mitral regurgitation. Since the PASCAL 10 and PASCAL 5 systems differ in size, mitral valve orifice area (MVOA) reduction could theoretically differ as well. Thus, we compared MVOA reduction between patients treated with the PASCAL P10 and P5 systems. 

Methods: 53 patients undergoing MV-TEER between April 2021 and February 2022 were analyzed using 2D and 3D intraprocedural transesophageal echocardiography. MVOA were measured before and after device implantation. To achieve accurate results, only patients who had the device positioned between the A2 and P2 segment of the anterior and posterior MV leaflet were included. Patients were further stratified by MR etiology.

Results: Relative MVOA reduction was found to be similar in the overall cohort (P10: 48.5±26.7% vs. P5: 47.7±17.2%; p=0.91) starting from comparable preprocedural MVOAs (4.7±1.6cm² vs. 4.3±1.7cm²; p=0.47). 37 out of 53 patients (69.8%) were found to have FMR.  A reduction of MVOA was observed in DMR (P10: 44.3±38.0%, P5: 25.0±27.0%, p=0.42) and FMR (P10: 50.7±18.7%, P5: 53.0±9.3%, p=0.69) patients. 

Conclusion: Both the P10 and P5 PASCAL systems have similar effects on mitral valve orifice areas in the process of MV TEER irrespective of MR etiology.