title: Acute reduction of functional mitral regurgitation in canine model using an epicardial device.
abstract: 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.
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland, Ohio, USA.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Akiyama
authors.forename: Zoran B
authors.initials: ZB
authors.lastname: Popović
authors.forename: Keiji
authors.initials: K
authors.lastname: Kamohara
authors.forename: Faruk
authors.initials: F
authors.lastname: Cingoz
authors.forename: Masao
authors.initials: M
authors.lastname: Daimon
authors.forename: Chiyo
authors.initials: C
authors.lastname: Ootaki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ootaki
authors.forename: Maureen
authors.initials: M
authors.lastname: Martin
authors.forename: Jenny
authors.initials: J
authors.lastname: Liu
authors.forename: Michael W
authors.initials: MW
authors.lastname: Kopcak
authors.forename: Raymond
authors.initials: R
authors.lastname: Dessoffy
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fukamachi
mesh_terms: 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