National Heart Centre Singapore pioneers advanced heart valve repair in Southeast Asia with new minimally invasive treatment

Singapore, 23 June 2025 – For 77-year-old Mrs Ong, climbing stairs or walking a short distance to the market had become increasingly difficult due to her leaky heart valve. Today, she moves about freely, thanks to an advanced heart treatment recently introduced at the National Heart Centre Singapore (NHCS).

NHCS has successfully performed Southeast Asia’s first PASCAL transcatheter valve repair (also known as transcatheter edge-to-edge repair), offering new hope to patients with moderate-to-severe and severe mitral regurgitation who were previously considered too high-risk for conventional surgical repair or valve replacement.  

FROM DAILY STRUGGLES TO RENEWED ENERGY: A PATIENT’S JOURNEY

"I used to feel breathless even walking short distances at home," recalls Mrs Ong, who discovered her condition in July 2024. Traditional open-heart surgery was deemed to be higher risk due to her other medical conditions. In February 2025, Mrs Ong became Singapore's first patient to undergo the PASCAL procedure. “The day after the procedure, I was already back home and doing my usual activities like bathing and walking, and after a week, I could do some light household chores."

A CRITICAL SOLUTION FOR SINGAPORE'S AGING POPULATION

The introduction of the PASCAL procedure addresses a pressing healthcare challenge globally, where approximately 3 percent of those aged over 70 suffer from at least moderate-to-severe mitral regurgitation and with the prevalence increasing with age¹. This condition occurs when the heart’s mitral valve does not close tightly, causing blood to flow backward in the heart instead of to the rest of the body. If left untreated, it can lead to breathlessness and fatigue, in addition to a high mortality rate especially in those with existing heart failure. With Singapore's rapidly ageing population, the need for safer, less invasive treatment options becomes increasingly crucial.

SAFER AND LESS INVASIVE TREATMENT OFFERING ENHANCED PRECISION

The PASCAL procedure repairs faulty heart valves without the need for open-heart surgery. Doctors make a small incision in the leg and guide the specialised PASCAL device up to the heart using a thin tube. The device works like a tiny clip, holding the leaky heart valve in place so that it can close properly and pump blood normally again.  Most patients can return home within days of the procedure rather than weeks, typically required after traditional open-heart surgery.

"The PASCAL device's innovative design allows us to repair damaged heart valves with precision and control, all through a small incision. Patients can typically return home to their loved ones and to their regular activities within days, all while experiencing lesser discomfort and speedier recovery,” said Assistant Professor Wong Ningyan, Consultant, Department of Cardiology, NHCS, who was part of the multidisciplinary team comprising interventional cardiologists, echocardiologists, radiographers and nurses, that performed Mrs Ong’s mitral valve repair.

EXPANDING TREATMENT OPTIONS

As Asia's pioneer in heart valve management, the addition of this new treatment enables NHCS to offer an even wider range of advanced and minimally invasive valve procedures² into our current suite of treatments, including MitraClip, Transcatheter Aortic Valve Implantation (TAVI) and advanced treatments for mitral, tricuspid, and pulmonary valve conditions, alongside our established surgical expertise. This allows our medical team to evaluate and recommend the most appropriate treatment approach, tailored to each patient's health condition. With extensive experience and expertise, NHCS is poised to continue leading as the regional referral centre for advanced cardiac care.

"By expanding our treatment options, we can now offer more personalised care appropriate for each patient's unique health needs,” said Professor Yeo Khung Keong, Chief Executive Officer and Senior Consultant, Department of Cardiology, NHCS. "For patients who previously had few alternatives, this advancement could mean the difference between continued suffering and a significantly improved quality of life. This reflects our unwavering commitment to bringing cutting-edge cardiovascular care to Singapore." Prof Yeo was also part of the team who performed Mrs Ong’s mitral valve repair. 

References:

1. Global Prevalence of Mitral Regurgitation: A Systemic Review and Meta-Analysis of Population-Based Studies.
2. New Minimally Invasive Treatments Offered In NHCS Offer Hope For Patients With Severe Heart Valve Disease

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About the National Heart Centre Singapore

The National Heart Centre Singapore (NHCS) is a leading national and regional referral centre for cardiovascular diseases, offering 185 beds and a comprehensive range of cardiac care services from preventive to rehabilitative. Ranked #12 as the World’s Best Cardiology Hospital by Newsweek 2025, NHCS’s clinical outcomes are consistently recognised at the international level, meeting or exceeding global standards. It is also the only facility in Singapore providing heart transplantation programme.

As an academic medical centre, NHCS is committed to training healthcare professionals and advancing cardiovascular health through cutting-edge translational research in collaboration with local and international collaborators.

For more information, please visit: www.nhcs.com.sg

Factsheet

Technical overview of PASCAL transcatheter edge-to-edge repair (TEER) system:

• Two device sizes: PASCAL (P10, 10mm width) and PASCAL Ace (6mm width)
• Central spacer helps reduce tension on mitral leaflets and promotes better leaflet coaptation
• Three independent movement components on the delivery system that enhances flexibility and manoeuvrability during the procedure
• Designed to reduce risk of chordal entanglement and improve procedural control

Above images courtesy of Edwards Lifesciences.

Annex
Suggested Caption: Medical team at National Heart Centre Singapore performing Southeast Asia's first PASCAL transcatheter edge-to-edge repair procedure in the Cardiac Catheterisation Laboratory on 4 February 2025.

Click here for high-res version of the above images.

Suggested Caption: Mrs Ong, 77, during her physiotherapy session at the National Heart Centre Singapore. Four months after undergoing Southeast Asia's first PASCAL transcatheter edge-to-edge repair procedure, she continues her steady recovery through regular rehabilitation exercises.

Click here for high-res version of the above image.