Abstract 4489: Transesophageal Echocardiography Evaluation of Percutaneous Repair of Mitral Valve Using CARILLON™ Device. Single-Center Procedural Results in Consecutive Patients
Background: Despite recent advancements, Functional Mitral Regurgitation (FMR), secondary to dilated cardiomyopathy remains a common clinical problem. Conventional cardiac surgery therapies have high procedural risk and therefore new techniques for percutaneous repair of mitral valve are being developed.
Aim. The purpose of the study was to verify the acute efficacy of percutaneous mitral valve repair in patients with FMR by transesophageal echocardiography (TEE)
Methods: We analyzed consecutive cases of percutaneous mitral valve repair with CARILLON™ Mitral Contour System™ (Cardiac Dimensions® Inc.) performed in a single center. The technique is based on implantation into the coronary venous system, where the device applies tension to the mitral ring in order to improve coaptation of the leaflets. TEE was performed during the procedure in the cath lab. Measurements before and immediately after the device release at the end of the procedure are given.
Results The procedure was attempted in 17 cases of secondary MR with no apparent organic changes on the leaflets. Successful implantation of the device was performed in 13 patients (12M and 1F, aged 48 – 67 yrs). The TEE parameters of the MR significantly changed after the procedure as compared to before the procedure, including vena contracta (0.43±0.13 vs 0.68±0.16cm, p=0.024), EROA (0.21±0.06 vs 0.27±0.08cm 2, p=0.019) and MR jet area/LA area (37.31 ±11,51 vs 53.82±14,14%, p=0.001). In 4 patients the device was recaptured due to compromised circumflex artery (3pts) and/or lack of measurable improvement in TEE (2 pts). No procedural complications were observed.
Conclusion The implantation of CARILLON™ system is feasible and safe in patients with Functional MR. Initial observations on efficacy justify completion of large clinical trials aiming at establishing the role of the technique in clinical practice.