Published online before print February 6, 2006, doi: 10.1161/CIRCULATIONAHA.105.591602
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(Circulation. 2006;113:851-855.)
© 2006 American Heart Association, Inc.
Valvular Heart Disease |
Percutaneous Transvenous Mitral Annuloplasty
Initial Human Experience With Device Implantation in the Coronary Sinus
From St Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.G.W., B.I.M., M.C., C.R.T., J.M.), and University Hospital of Lund, Lund, Sweden (J.H., P.O.K., J.O.S.).
Correspondence to John G. Webb, MD, Director of Interventional Cardiology, St. Paul’s Hospital, Room 5202A, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6. E-mail webb{at}providencehealth.bc.ca
Received September 26, 2005; revision received November 9, 2005; accepted December 2, 2005.
Background— Mitral annuloplasty is the most common surgical procedure performed for ischemic mitral regurgitation (MR). Surgical mitral annuloplasty is limited by morbidity, mortality, and MR recurrence. We evaluated the safety and feasibility of a transvenous catheter-delivered implantable device to provide a percutaneous alternative to surgical mitral annuloplasty.
Methods and Results— Five patients with chronic ischemic MR underwent percutaneous transvenous implantation of an annuloplasty device in the coronary sinus. Implantation was successful in 4 patients. Baseline MR in the entire group was grade 3.0±0.7 and was reduced to grade 1.6±1.1 at the last postimplantation visit when the device was intact or the last postprocedural visit in the patient in whom the device was not successfully implanted. Separation of the bridge section of the device occurred in 3 of 4 implanted devices and was detected at 28 to 81 days after implantation. There were no postprocedural device-related complications.
Conclusions— Percutaneous implantation of a device intended to remodel the mitral annulus is feasible. Initial experience suggests a possible favorable effect on MR. Percutaneous transvenous mitral annuloplasty warrants further evaluation as a less invasive alternative to surgical annuloplasty.
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