Document Detail


Coapsys mitral annuloplasty for chronic functional ischemic mitral regurgitation: 1-year results.
MedLine Citation:
PMID:  16368332     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Untreated functional ischemic mitral regurgitation (MR) leads to reduced survival in patients undergoing coronary artery bypass grafting (CABG). However, mitral repair or replacement increases mortality and morbidity over CABG alone. The Myocor Coapsys annuloplasty system potentially reduces these risks by facilitating MR reduction on a beating heart without atriotomy. We present data from the first 11 patients completing 1-year follow-up of a total of 34 implanted patients. METHODS: Patients referred for CABG with preoperative grade 2 or greater ischemic functional MR were included in this study. Patients with structural valve defects or who demonstrated MR less than grade 2 after CABG, despite hemodynamic challenge, were intraoperatively excluded. Coapsys consists of two epicardial pads connected by a flexible chord implanted by passing the chord across the left ventricle with special instruments without cardiopulmonary bypass. The system was sized to reduce critical valve dimensions and MR. Serial clinical and echocardiographic data were collected out to 1 year. RESULTS: Mean age was 58.1 +/- 6.6 years and mean ejection fraction, 38.5% +/- 7.1%. From baseline to 1-year follow-up, effect on MR grade, MR jet area (cm2), and New York Heart Association class were, respectively, 2.9 +/- 0.5 to 1.1 +/- 0.8, 7.4 +/- 2.9 to 3.0 +/- 1.6, and 2.5 +/- 0.5 to 1.2 +/- 0.4 (all p < 0.05 versus baseline). During follow-up, there were no deaths, device failures, reemergence of grade 3 or 4 MR, heart failure readmission, or valve reoperations. CONCLUSIONS: The Coapsys annuloplasty system is effective in reducing functional ischemic MR and improving NYHA class. The initial data are encouraging and suggest that the device is safe and benefits are sustained at 1 year.
Authors:
Yugal K Mishra; Sanjay Mittal; Pravesh Jaguri; Naresh Trehan
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  81     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-21     Completed Date:  2006-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  42-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, Escorts Heart Institute and Research Centre, New Delhi, India. dryugal@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Chronic Disease
Coronary Artery Bypass, Off-Pump
Echocardiography, Doppler, Color
Echocardiography, Transesophageal
Equipment Design
Feasibility Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mitral Valve Insufficiency / etiology,  surgery*,  ultrasonography
Myocardial Ischemia / complications*,  surgery,  ultrasonography
Papillary Muscles / surgery
Patient Selection
Prostheses and Implants*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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