Acute reduction of functional mitral regurgitation in canine model using an epicardial device.
OBJECTIVE
This study evaluated the short-term feasibility of a novel epicardial device that treats functional mitral regurgitation by simultaneously changing the mitral and the left ventricular geometry.


METHODS
We implanted a prototype device that consists of 2 tissue anchors, a deflector, and a flexible tightening chord in 7 mongrel dogs with heart failure and functional mitral regurgitation induced by rapid ventricular pacing. Hemodynamic and echocardiographic data were obtained before and after device implantation.


RESULTS
The device acutely reduced the mitral regurgitation grade from 3.2 +/- 0.3 to 0.9 +/- 0.5 (p < 0.001). Left ventricular end-diastolic volume (79.6 +/- 23.6 to 61.2 +/- 16.9 mL; p = 0.004) and end-systolic volume (63.1 +/- 17.3 to 49.2 +/- 12.3 mL; p = 0.006) decreased substantially. End-systolic elastance significantly increased from 1.9 +/- 1.0 to 2.6 +/- 1.4 mm Hg/mL (p = 0.02). Device implantation did not alter coronary perfusion.


CONCLUSIONS
The epicardial device acutely reduced functional mitral regurgitation and improved left ventricular geometry. Further studies are required to demonstrate the long-term safety and efficacy of this concept.
Akiyama
Masatoshi
M
Department of Biomedical Engineering, Lerner Research Institute, Cleveland, Ohio, USA.
Popović
Zoran B
ZB
Kamohara
Keiji
K
Cingoz
Faruk
F
Daimon
Masao
M
Ootaki
Chiyo
C
Ootaki
Yoshio
Y
Martin
Maureen
M
Liu
Jenny
J
Kopcak
Michael W
MW
Dessoffy
Raymond
R
Fukamachi
Kiyotaka
K
D000818:Animals; D004285:Dogs; D004452:Echocardiography; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics / Q000502:physiology; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000503:physiopathology / Q000601:surgery*; D009200:Myocardial Contraction / Q000502:physiology; D010496:Pericardium / Q000601:surgery; D011474:Prosthesis Design; D013537:Sutures