Percutaneous Trans-Coronary Venous Mitral Annuloplasty in Patients With Functional Mitral Regurgitation: Analysis of Poznan Carillon Registry Data.
OBJECTIVE
The purpose of our study is to verify, whether percutaneous mitral annuloplasty results in reverse remodeling in patients with functional mitral regurgitation (FMR) and impaired ejection fraction (EF) and to investigate which echo parameters may help in prediction of the efficacy of the procedure.


BACKGROUND
FMR exacerbates left ventricular (LV) dilatation and contributes to both LV remodeling and heart failure.


METHODS
We analyzed baseline and 1 month follow-up data in 22 consecutive patients with FMR, who underwent successful percutaneous trans-coronary venous mitral annuloplasty with the Carillon device.


RESULTS
Significant reduction of FMR echo parameters, including vena contracta (VC), effective regurgitant orifice area (EROA), and regurgitant volume (RV) were observed and maintained throughout 1 month follow up and did not correlate with baseline annular, LV or with the left atrial diameters. Baseline mitral tenting area correlated negatively with the relative improvement (% difference) of EROA (r = -0.5898) and RV (r = -0.4363), but not with VC (r = 0.1341). In addition, increased EF as well as a significant reduction in left ventricular diameters were noted. The increase in EF negatively correlated with the change in EROA (r = -0.50058), PISA (r = -0.5327), and RV (r = -0.5457). Baseline mitral tenting area significantly correlated with the 1 month change in EF (r = 0.5946) and stroke volume (r = 0.6913).


CONCLUSIONS
The improvement of FMR after treatment with the Carillon device is associated with LV reverse remodeling and an increase in systolic performance, that correlates with the reduction in mitral regurgitation, being not dependent on baseline heart diameters. Mitral tenting area seems to be an important parameter in prediction of benefit from percutaneous mitral annuloplasty.
Department of Interventional Cardiology, Poznan University of Medical Sciences, Poznan, Poland.|HCP Medical Center, Pozan, Poland.
Piotr
P
Kałmucki
J. Strus City Hospital Poznan, Pozan, Poland.
Olga
O
Jerzykowska
Department of Interventional Cardiology, Poznan University of Medical Sciences, Poznan, Poland.|HCP Medical Center, Pozan, Poland.
Rafał
R
Dankowski
Department of Interventional Cardiology, Poznan University of Medical Sciences, Poznan, Poland.|HCP Medical Center, Pozan, Poland.
Artur
A
Baszko
Department of Interventional Cardiology, Poznan University of Medical Sciences, Poznan, Poland.
Lucyna
L
Kramer
Department of Interventional Cardiology, Poznan University of Medical Sciences, Poznan, Poland.|HCP Medical Center, Pozan, Poland.
Andrzej
A
Szyszka
Department of Interventional Cardiology, Poznan University of Medical Sciences, Poznan, Poland.|HCP Medical Center, Pozan, Poland.
Tomasz
T
Siminiak
D000328:Adult; D000368:Aged; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D006333:Heart Failure / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D011044:Poland; D020127:Recovery of Function; D012042:Registries; D013318:Stroke Volume; D016896:Treatment Outcome; D020257:Ventricular Remodeling