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Masiero et al. Mini-invasive Surg 2020;4:71 I http://dx.doi.org/10.20517/2574-1225.2020.56 Page 11 of 12

[Videos 2 and 3]. When sufficient and straight leaflet insertion was confirmed, the clasps were dropped,
and device was closed. Immediately after, the residual MR and transvalvular gradient were systematically
assessed to confirm optimal MR reduction before final deployment [Figures 5 and 6] [Video 4].
Remarkably, a drop in the mean left-atrial pressure from 16 to 8 mmHg was observed. Mild regurgitation
was confirmed at TTE before discharge (in particular: residual mean MV gradient of 3 mmHg, effective
2
2
orifice area of 14 mm and MV area of 3 cm ) [Figure 7] and at 30-days follow-up with acceptable mitral
gradient and clinical improvement (NYHA class I-II).
CONCLUSION
The percutaneous treatment of functional MR through transcatheter “edge-to-edge” leaflet repair has
recently risen as a viable and safe alternative to conventional surgery in selected patients with severe disease
who remain symptomatic despite maximally tolerated guideline-directed medical therapy and judged at
high surgical risk by a multidisciplinary and experienced heart team. Two devices are currently available,
the MitraClip and the PASCAL Repair Systems, with peculiar technical aspects and evidence.

DECLARATIONS
Authors’ contributions
Participated to the conception and the drafting of the manuscript, its critical revision for important
intellectual content and the final approval of the submitted text; agreement for all aspects of the work
ensuring that questions related to the accuracy or integrity of any part of the work are appropriately
investigated and resolved: Masiero G, Rodinò G, Tarantini G

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Tarantini G reports honoraria for lectures from Abbott Vascular and Edwards Lifesciences; Masiero G and
Rodinò G declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

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