Novel device to change left ventricular shape for heart failure treatment: device design and implantation procedure.
The Myocor Myosplint is designed to decrease left ventricular (LV) wall stress by changing LV shape, thus improving contractile function in dilated hearts. This shape change is accomplished by surgically placing three Myosplints perpendicular to the LV long axis, drawing the LV walls inward, and creating a symmetric, bilobular LV. Specially designed instruments aid in the precise delivery of these devices. The purpose of this study was to test the safety and feasibility of the procedure in dogs. Dilated cardiomyopathy was induced in 40 healthy dogs (26.3+/-1.7 kg) by ventricular pacing at 230 beats per minute for an average of 25+/-4 days. Using epicardial echocardiography, we placed the Myosplints across the LV chamber, avoiding the major coronary arteries, papillary muscles, and mitral valve. Once placed, the Myosplints were used to draw the LV walls inward to a prescribed distance. In all cases, we successfully implanted three Myosplints without using cardiopulmonary bypass. There were no complications related to the device or procedure. Myosplint implantation to change LV shape is safe and repeatable on a beating cardiomyopathic canine heart. Further study of the procedure will be needed in humans.
Takagaki
M
M
Department of Biomedical Engineering, Lerner Research Institute, Cleveland, Ohio, USA.
McCarthy
P M
PM
Ochiai
Y
Y
Dessoffy
R
R
Doi
K
K
Vidlund
R
R
Mortier
T J
TJ
Schweich
C J
CJ
Fukamachi
K
K
D000818:Animals; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000628:therapy*; D004285:Dogs; D004452:Echocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006353:Heart-Assist Devices; D011474:Prosthesis Design; D019919:Prosthesis Implantation