Document Detail

Percutaneous mitral valve repair for chronic ischemic mitral regurgitation: a real-time three-dimensional echocardiographic study in an ovine model.
MedLine Citation:
PMID:  15851597     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although surgical annuloplasty is the standard repair for ischemic mitral regurgitation (IMR), its application is limited by high morbidity and mortality. Using 2D and real-time 3D echocardiography in an ovine model of chronic IMR, we evaluated the geometric impact and short-term efficacy of a percutaneous transvenous catheter-based approach for mitral valve (MV) repair using a novel annuloplasty device placed in the coronary sinus. METHODS AND RESULTS: Six sheep developed IMR 8 weeks after induced posterior myocardial infarction. An annuloplasty device optimized to reduce anterior-posterior (A-P) mitral annular dimension and MR was placed percutaneously in the coronary sinus. Mitral annular A-P and commissure-commissure dimensions and MV tenting area (MVTa) in 3 parallel A-P planes (medial, central, and lateral) were assessed by real-time 3D echocardiography with 3D software. The annuloplasty device reduced MR jet area from 5.4+/-2.6 to 1.3+/-0.9 cm2 (P<0.01), mitral annular A-P dimension in both systole and diastole (24.3+/-2.5 to 19.7+/-2.4 mm; P<0.03; 31.0+/-3.9 to 24.7+/-2.1 mm; P<0.001), and MVTa at mid systole in all 3 planes (153+/-46 to 93+/-24 mm2, P<0.01; 140+/-47 to 88+/-23 mm2, P<0.03; and 103+/-23 to 87+/-26 mm2, P<0.03). CONCLUSIONS: Percutaneous coronary sinus-based mitral annuloplasty reduces chronic IMR by reducing mitral annular A-P diameter and MVTa. This suggests the potential clinical application of a new nonsurgical therapeutic approach in patients with IMR.
Masao Daimon; Takahiro Shiota; A Marc Gillinov; Motoya Hayase; Marc Ruel; William E Cohn; Steven J Blacker; John R Liddicoat
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Publication Detail:
Type:  Journal Article     Date:  2005-04-25
Journal Detail:
Title:  Circulation     Volume:  111     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-03     Completed Date:  2005-12-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2183-9     Citation Subset:  AIM; IM    
Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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MeSH Terms
Cardiac Surgical Procedures
Chronic Disease
Echocardiography, Three-Dimensional
Heart Catheterization
Mitral Valve / surgery*
Mitral Valve Insufficiency / surgery*
Models, Animal
Myocardial Ischemia*
Surgical Procedures, Minimally Invasive
Comment In:
Circulation. 2005 May 3;111(17):2154-6   [PMID:  15867192 ]

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