In patients with functional mitral regurgitation, MitraClip G4 and PASCAL demonstrated similarly high procedural success, durable MR reduction, and comparable clinical outcomes at 1 year.
Procedural success rates were nearly identical between MitraClip G4 and PASCAL systems in patients with functional mitral regurgitation.
One-year survival was comparable between patients treated with MitraClip G4 and those treated with PASCAL.
Freedom from heart failure hospitalization at 1 year did not differ significantly between the two transcatheter edge-to-edge repair systems.
Residual mitral regurgitation at 1 year was similar between MitraClip G4 and PASCAL groups.
New York Heart Association functional class at 1 year was not significantly different between the two device groups.
The study population consisted of 319 consecutive patients with severe symptomatic functional mitral regurgitation treated at a single center.
This research suggests that two commonly used minimally invasive heart valve repair devices — MitraClip G4 and PASCAL — produce very similar results when used to treat a condition called functional mitral regurgitation (FMR). FMR occurs when the mitral valve leaks blood backward due to heart muscle weakness or an enlarged heart chamber. Both devices use a catheter-based approach to clip the leaky valve shut without open-heart surgery, making them options for patients considered too high-risk for traditional surgery. The study followed 319 patients treated at a single hospital over two years and used a statistical technique called propensity score matching to fairly compare 116 patient pairs treated with one device or the other. The findings showed that both devices were highly effective at reducing the valve leak during the procedure (roughly 98% success in both groups), and these improvements held up over one year of follow-up. Survival rates at one year were nearly identical — about 87% in both groups — and rates of rehospitalization for heart failure and symptom improvement were also statistically indistinguishable between the two devices. This research suggests that clinicians and patients can expect similar outcomes from either system, meaning the choice between devices may come down to other factors such as operator experience, specific patient anatomy, or device availability rather than meaningful differences in effectiveness or safety.
Ackermann P, de Waha S, Otto W, Rotta Detto Loria J, van Kampen A, Leontyev S, et al.. (2026). Transcatheter Edge-to-Edge Repair With MitraClip G4 System Compared With PASCAL System in Patients With Functional Mitral Regurgitation: A Propensity Score-Matched Analysis.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.044698