Abstract 2206: Improved Left Ventricular Shape and Myocardial Mechanics after Transcatheter Left Ventricular Reconstruction (Dor Procedure) in Sheep with Chronic Left Apical Aneurysm: An Intracardiac and Transthoracic Echocardiography Study
Objectives: Remote ventricular reconstruction (RVR) is a novel catheter-based, transmural, direct epicardial approach to LV reconstruction for LV apical aneurysm (AN). We have previously shown that LV volume and EF are improved after RVR. This study was to evaluate the changes in LV geometry and myocardial mechanics immediately after RVR.
Methods: 4 sheep with LV apical AN after coronary ligation underwent RVR 8 weeks post ligation. RVR was done using a proprietary catheter system (PVR, BioVentrix, San Ramon, CA). LV apical curvature (K = 1/R) by intracardiac echocardiography, and apical mechanics (Circumferential-CS%-, Radial-RS%, and Rotation-ROTdeg) by transthoracic echocardiography were measured prior to and immediately after RVR with a feature-tracking algorithm called Velocity Vector Imaging (Siemens, CA).
Results: Shape: LV apical end-diastolic and end-systolic K increased after RVR (Fig 1⇓, 2⇓). Mechanics: Before RVR, SAX-AP showed paradoxical increase in area in systole, markedly reduced CS, RS and apical ROT. After RVR, apical CS, RS and ROT improved significantly. Table⇓ shows data from all sheep (p < 0.05).
Conclusions: LV apical shape and mechanics improved after catheter-based RVR. Combined with the previously demostrated beneficial effects on LV volume and EF, these data show gemoteric, functional and mechanical reverse LV remodeling after RVR.