Techniques for transcatheter mitral valve repair are derived from surgical procedures such as the Alfieri edge-to-edge repair aiming for leaflet approximation. The MitraClip was the first widely available transcatheter system with approval for the treatment of mitral regurgitation (MR). However, since its first implantation in 2003, and despite more than 100 000 procedures performed worldwide, there have been only minimal design modifications, leaving some intrinsic limitations, which especially come to light in complex anatomical settings. To address some of these limitations, the Edwards PASCAL transcatheter valve repair system has been developed and has obtained CE mark approval for the treatment of the mitral valve in 2019 and for the tricuspid valve in 2020. Patients had symptomatic MR are not eligible for surgery, and had anatomical complexity making successful treatment with MitraClip less likely or off-label. A summary of the experience showed feasibility and efficacy of the procedure with a high rate of technical success.