First-in-man implantation of left ventricular partitioning device in a patient with chronic heart failure: twelve-month follow-up.
BACKGROUND
The ventricular partitioning device (VPD) (Cardiokinetix Inc., Redwood City, Calif) is a novel device that is deployed percutaneously in the left ventricle in patients with anteroapical regional wall motion abnormalities after a myocardial infarction (MI) to partition the ventricle and segregate the dysfunctional region. In this case report we present the first implantation of the VPD in a human, with a 12-month efficacy and safety follow-up.


RESULTS
A 48-year-old man had an anterior MI in 2004. A coronary angiogram showed an occlusion of the proximal segment of the left anterior descending artery with no stenosis on other major epicardial vessels. Echocardiography revealed a dilated left ventricle (62 mm) with anteroapical wall motion abnormalities, no apical thrombus, a calculated ejection fraction of 26.8% (by Simpson biplane formula), and an end-systolic volume index (ESVi) of 76.8 mL/m(2). The VPD implant was delivered percutaneously from the femoral artery by the standard techniques for left-sided heart catheterization. The postimplantation course was uneventful. Echocardiography on discharge showed the VPD implanted at the apex, with a left ventricular ejection fraction of 30.9% and an ESVi of 57.2 mL/m(2). Left ventricular ejection fraction and ESVi remained improved during the 12-month follow-up.


CONCLUSIONS
This case report demonstrates that VPD implantation in this particular patient was feasible and that it may provide a nonsurgical approach to prevent or reverse left ventricle remodeling.
Otasevic
Petar
P
Dedinje Cardiovascular Institute and Belgrade University School of Medicine, Belgrade, Serbia.
Sagic
Dragan
D
Antonic
Zelimir
Z
Nikolic
Serjan D
SD
Khairakhan
Alexander
A
Radovancevic
Branislav
B
Gradinac
Sinisa
S
D006328:Cardiac Catheterization; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging / Q000628:therapy*; D002908:Chronic Disease; D017023:Coronary Angiography; D004452:Echocardiography; D004867:Equipment Design; D004869:Equipment Safety; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D016896:Treatment Outcome