Document Detail

Feasibility and short-term efficacy of percutaneous mitral annular reduction for the therapy of heart failure-induced mitral regurgitation.
MedLine Citation:
PMID:  14530194     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Mitral regurgitation (MR) frequently accompanies congestive heart failure (CHF) and is associated with poorer prognosis and more significantly impaired symptomatic status. Although surgical mitral valve annuloplasty has the potential to offer benefit, concerns about the combined surgical risk and possible effects on ventricular performance have limited progress. We evaluated the feasibility and short-term efficacy of a novel device placed in the coronary sinus to reduce MR in the setting of CHF. METHODS AND RESULTS: CHF and MR were induced in 9 adult sheep by rapid ventricular pacing for 5 to 8 weeks. A mitral annular constraint device was implanted percutaneously through the right internal jugular vein in the coronary sinus and great cardiac vein to create a short-term stable reduction (24.9+/-2.5%) in the mitral annular septal-lateral dimension as assessed echocardiographically. Right and left heart pressures and cardiac output were determined before and 15 minutes after device implantation. MR extent was examined echocardiographically and expressed as a ratio of left atrial area (MR/LAA). After device placement, MR was substantially reduced from an MR/LAA of 42+6% to 4+/-3% (P<0.01). In association, mean pulmonary wedge pressure was significantly reduced (26+/-3 to 18+/-3 mm Hg; P<0.01) and mean cardiac output significantly increased (3.4+/-0.3 to 4.3+/-0.4 L/min; P=0.01). CONCLUSIONS: In this model of CHF, percutaneous placement of a mitral annular constraint device in the coronary sinus resulted in the short-term elimination or minimization of MR and was accompanied in the short term by favorable hemodynamic effects.
David M Kaye; Melissa Byrne; Clif Alferness; John Power
Related Documents :
1622614 - Value of pulmonary venous flow characteristics in the assessment of severity of native ...
17347034 - Alteration of myocardial sarcoplasmic reticulum ca2+-atpase and na+-ca2+ exchanger expr...
7786914 - Radionuclide ventriculography in dynamic cardiomyoplasty.
18558474 - The angle of the components of the common atrioventricular valve predicts the outcome o...
2598214 - Lactate dehydrogenase and its isoenzyme activities in different parts of the normal hum...
10382834 - The future of best practice.
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2003-10-06
Journal Detail:
Title:  Circulation     Volume:  108     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-14     Completed Date:  2003-11-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1795-7     Citation Subset:  AIM; IM    
Wynn Department of Metabolic Cardiology, Baker Heart Research Institute, P.O. Box 6492, St Kilda Rd Central, Melbourne, Victoria 8008, Australia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cardiac Output
Cardiac Pacing, Artificial / adverse effects
Cardiomyopathy, Dilated / complications
Disease Models, Animal
Equipment Design
Feasibility Studies
Heart Failure / complications*
Jugular Veins
Mitral Valve / surgery*
Mitral Valve Insufficiency / etiology,  surgery*
Prostheses and Implants*
Pulmonary Wedge Pressure

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

Previous Document:  Endovascular edge-to-edge mitral valve repair: short-term results in a porcine model.
Next Document:  Endothelial dysfunction and cardiovascular risk prediction in peripheral arterial disease: additive ...