Percutaneous suture edge-to-edge repair of the mitral valve.
OBJECTIVE
To describe a new approach to percutaneous mitral valve repair and an illustrative first-in-man experience, we introduce a suture mediated "double orifice", "edge-to-edge" procedure which can be an effective surgical therapy for mitral regurgitation (MR) in selected patient.


RESULTS
We describe a novel percutaneous approach to double orifice mitral repair utilising an intra-cardiac suture based system. The procedure was performed in 15 patients in four international centres. Endovascular suture based double orifice mitral repair was feasible with an acute reduction in the severity of MR by > or = 1 grade in nine of 15 patients. At 30 days improvement in MR appeared durable in six patients. Clinical utility was limited by technical difficulties, the inadequacies of current imaging modalities and suture dehiscence.


CONCLUSIONS
Percutaneous endovascular suture based cardiac repair is feasible. However, in utilising the current device clinical benefit was limited and the repair not durable. In the future, similar endovascular approaches may enable more complex cardiac repair.
Webb
John G
JG
St. Paul's Hospital, University of British Columbia, Vancouver, Canada. webb@providencehealth.bc.ca
Maisano
Francesco
F
Vahanian
Alec
A
Munt
Brad
B
Naqvi
Tasneem Z
TZ
Bonan
Raoul
R
Zarbatany
David
D
Buchbinder
Maurice
M
D000368:Aged; D002140:California; D002170:Canada; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D015641:Radiography, Interventional; D012720:Severity of Illness Index; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome