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使用新型PASCAL系统进行二尖瓣瓣叶修复:来自德国多中心经验的早期真实世界数据。

Mitral valve leaflet repair with the new PASCAL system: early real-world data from a German multicentre experience.

作者信息

Kriechbaum Steffen D, Boeder Niklas F, Gaede Luise, Arnold Martin, Vigelius-Rauch Ursula, Roth Peter, Sander Michael, Böning Andreas, Bayer Matthias, Elsässer Albrecht, Möllmann Helge, Hamm Christian W, Nef Holger M

机构信息

Department of Cardiology and Angiology, Medical Clinic I, Universitätsklinikum Gießen and Marburg, University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.

Medical Clinic 2, University Hospital of Erlangen, Giessen, Germany.

出版信息

Clin Res Cardiol. 2020 May;109(5):549-559. doi: 10.1007/s00392-019-01538-3. Epub 2019 Aug 26.

Abstract

AIMS

To examine the clinical experience and practical use of the PASCAL transcatheter valve repair system (Edwards Lifesciences, Irvine, CA, USA) and to report some of the first clinical results.

METHODS AND RESULTS

A total of 18 consecutive patients with severe, symptomatic mitral regurgitation (MR) were included in this German multicentre registry. All patients underwent clinical, echocardiographic, and laboratory assessment prior to the PASCAL procedure and before hospital discharge. MR was classified as functional in 6 patients, degenerative in 2, and combined in 10. All except one received a single PASCAL implant. The preprocedural severe MR present in all patients was reduced: grade 0 in 4 (22.2%), grade I in 11 (61.1%), grade II in 3 (16.7%). The v-wave was significantly reduced from 31.7 ± 9.5 to 18 ± 7.7 mmHg (p < 0.001). Independent leaflet capture, performed in 4 (22.2%) of the patients, wide clasps, and the 10-mm central spacer are features of the PASCAL device to optimize mitral leaflet repair. There were no periprocedural complications.

CONCLUSION

PASCAL is a safe and effective mitral valve repair device for the treatment of severe MR. Device-specific features allow valve repair tailored to the individual anatomy of the underlying mitral pathology in each patient.

摘要

目的

探讨PASCAL经导管瓣膜修复系统(美国加利福尼亚州尔湾市爱德华兹生命科学公司)的临床经验和实际应用,并报告一些首批临床结果。

方法与结果

该德国多中心注册研究共纳入18例连续性有症状的重度二尖瓣反流(MR)患者。所有患者在接受PASCAL手术前及出院前均接受了临床、超声心动图和实验室评估。6例患者的MR分类为功能性,2例为退行性,10例为混合型。除1例患者外,所有患者均植入了单个PASCAL装置。所有患者术前存在的重度MR均有所减轻:4例(22.2%)为0级,11例(61.1%)为Ⅰ级,3例(16.7%)为Ⅱ级。v波从31.7±9.5显著降至18±7.7 mmHg(p<0.001)。4例(22.2%)患者进行了独立瓣叶捕获、宽扣环和10毫米中央间隔器,这些是PASCAL装置优化二尖瓣叶修复的特点。围手术期无并发症发生。

结论

PASCAL是一种治疗重度MR的安全有效的二尖瓣修复装置。特定装置的特点允许根据每位患者潜在二尖瓣病变的个体解剖结构进行瓣膜修复。

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