Percutaneous transvenous mitral annuloplasty: initial human experience with device implantation in the coronary sinus.
BACKGROUND
Mitral annuloplasty is the most common surgical procedure performed for ischemic mitral regurgitation (MR). Surgical mitral annuloplasty is limited by morbidity, mortality, and MR recurrence. We evaluated the safety and feasibility of a transvenous catheter-delivered implantable device to provide a percutaneous alternative to surgical mitral annuloplasty.


RESULTS
Five patients with chronic ischemic MR underwent percutaneous transvenous implantation of an annuloplasty device in the coronary sinus. Implantation was successful in 4 patients. Baseline MR in the entire group was grade 3.0+/-0.7 and was reduced to grade 1.6+/-1.1 at the last postimplantation visit when the device was intact or the last postprocedural visit in the patient in whom the device was not successfully implanted. Separation of the bridge section of the device occurred in 3 of 4 implanted devices and was detected at 28 to 81 days after implantation. There were no postprocedural device-related complications.


CONCLUSIONS
Percutaneous implantation of a device intended to remodel the mitral annulus is feasible. Initial experience suggests a possible favorable effect on MR. Percutaneous transvenous mitral annuloplasty warrants further evaluation as a less invasive alternative to surgical annuloplasty.
Webb
John G
JG
St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. webb@providencehealth.bc.ca
Harnek
Jan
J
Munt
Brad I
BI
Kimblad
Per Ola
PO
Chandavimol
Mann
M
Thompson
Christopher R
CR
Mayo
John R
JR
Solem
Jan O
JO
D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D004868:Equipment Failure; D005240:Feasibility Studies; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000473:pathology / Q000628:therapy*; D017202:Myocardial Ischemia; D016896:Treatment Outcome