Mitral valve repair: What the ACORN Trial taught us.
Progressive left ventricular remodeling is characterized by dilation of the left ventricle with a change in the heart from an elliptical shape to a more spherical shape. This change is part of the unfavorable natural history in patients with heart failure. The CorCap Cardiac Support Device (Acorn Cardiovascular, St. Paul, MN) is a mesh device that is implanted around the heart to reduce wall stress and the first therapy specifically designed to address left ventricular remodeling. The CorCap was studied in a large, prospective, randomized, multicentered trial. This study demonstrated safety and effectiveness of the CorCap in patients with advanced heart failure and remodeled ventricles. Moreover, it provided interesting insights into mitral valve surgery in patients with heart failure. These insights and a review of the ACORN (Assessment of a Cardiac Support Device [CSD] in Patients With Heart Failure) trial are discussed in this article.
Ali
Mir Wasif
MW
Department of Surgery, University of Michigan, Ann Arbor, 48109, USA.
Bolling
Steven F
SF
D002302:Cardiac Output; D006333:Heart Failure / Q000150:complications* / Q000473:pathology; D019918:Heart Valve Prosthesis Implantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D020257:Ventricular Remodeling