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
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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.
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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

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