title: Evaluating the quality of implantation of percutaneous ventricular restoration device (Parachute®) by cardiac computed tomography.
abstract: BACKGROUND
  The Parachute is a novel percutaneously implanted ventricular partitioning device (VPD) that has emerged as a safe and feasible treatment option for patients with heart failure following anterior wall myocardial infarction. VPD efficacy is likely dependent on optimal device placement, but to date there are no published data examining the effect of device positioning on patient outcomes.
  
  
  RESULTS
  We retrospectively identified 32 patients successfully implanted with the Parachute device, all of whom underwent cardiac computed tomography (CCT) at baseline and after 6 months of follow-up. Patients were divided into two groups based on self-reported improvement in New York Heart Association (NYHA) functional class: "not improved NYHA" (n = 12) and "improved NYHA" (n = 20). There were significant differences between both groups with regard to device positioning on follow-up CCT. Compared to patients with "improved NYHA," patients with "not improved NYHA" had longer distances from device foot to left ventricular apex (8.0 ± 4.9 vs. 2.9 ± 4.6 mm; P = 0.01), and higher lateral angles (18.0 ± 14 vs. 9.1 ± 6.8 degrees; P = 0.02), respectively. There was no significant difference between the two groups in landing zone (45.4 ± 7. vs. 45.1 ± 6.9 mm; P = 0.92) and inferior angle (14.0 ± 11.9 vs. 14.3 ± 10.1 degrees; P = 0.95). There was a numerically larger malapposition area in the "not improved NYHA" group (5.1 ± 4.5 vs. 3.2 ± 2.2 cm2; P = 0.12).
  
  
  CONCLUSIONS
  Quality of Parachute implant impacted clinical outcome, these findings should be applied prospectively in helping operators to achieve optimal implant. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Mohamad Amer
authors.initials: MA
authors.lastname: Alaiti
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Anas
authors.initials: A
authors.lastname: Fares
authors.affiliation: Department of Medicine, Institute of Cardiology, University of Latvia, Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors.forename: Andrejs
authors.initials: A
authors.lastname: Erglis
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Lemba
authors.initials: L
authors.lastname: Nshisso
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Kashif
authors.initials: K
authors.lastname: Shaikh
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: DeCicco
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Marwan
authors.initials: M
authors.lastname: Nasif
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Alkhalil
authors.affiliation: Department of Cardiology, Vivantes Klinikum Im Friedrichshain Und Am Urban, Berlin, Germany and Rostock University Medical Center, Rostock, Germany.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ince
authors.affiliation: Division of Cardiovascular Medicine, the Ohio State University, Columbus, Ohio.
authors.forename: William T
authors.initials: WT
authors.lastname: Abraham
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Simon
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Costa
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Guilherme F
authors.initials: GF
authors.lastname: Attizzani
authors.affiliation: Department of Medicine, Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio.
authors.forename: Hiram G
authors.initials: HG
authors.lastname: Bezerra
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013318:Stroke Volume; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000502:physiology*
keywords: electron beam CT/multidetector CT; heart failure; imaging; interventional devices/innovation