Percutaneous Septal Sinus Shortening
- 16 May 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 113 (19), 2329-2334
- https://doi.org/10.1161/circulationaha.105.601518
Abstract
Background— The septal-to-lateral (SL) mitral annular diameter is increased in functional mitral regurgitation (MR). We describe a novel percutaneous technique (the percutaneous septal sinus shortening system) that ameliorates functional MR in an ovine model. Methods and Results— Sheep underwent rapid right ventricular pacing to obtain moderate to severe functional MR with SL enlargement. The percutaneous septal sinus shortening system was placed via standard interventional techniques consisting of a bridge (suture) element between interatrial septal wall and great cardiac vein anchors. Through progressive tensioning of the bridge element, direct SL shortening was achieved. Sheep underwent short-term (n=19) and long-term (n=4) evaluation after device implantation. In short-term studies, SL diameter decreased an average of 24% (32.5±3.5 to 24.6±2.4 mm; P P P =0.01) and MR reduction (1.8±0.5 before implantation to 0.2±0.1 at 30 days; P =0.01). Increased cardiac output, decreased wedge pressure, and decreased brain natriuretic peptide levels were observed in animals undergoing long-term device implantation. Conclusions— The percutaneous septal sinus shortening system is effective in ameliorating functional MR in an ovine tachycardia model. The procedure, which uses standard catheter techniques, can be deployed largely under fluoroscopic guidance. The unique bridge element appears durable and allows direct and precise SL shortening to a diameter optimal for MR reduction.Keywords
This publication has 25 references indexed in Scilit:
- The coronary sinus conduit function: Anatomical study (relationship to adjacent structures)EP Europace, 2005
- Annular or subvalvular approach to chronic ischemic mitral regurgitation?The Journal of Thoracic and Cardiovascular Surgery, 2005
- Percutaneous Mitral Annular Reduction Provides Continued Benefit in an Ovine Model of Dilated CardiomyopathyCirculation, 2004
- Effects of Paracommissural Septal-Lateral Annular Cinching on Acute Ischemic Mitral RegurgitationCirculation, 2004
- Beating Heart Catheter-Based Edge-to-Edge Mitral Valve Procedure in a Porcine ModelCirculation, 2004
- Does septal-lateral annular cinching work for chronic ischemic mitral regurgitation?The Journal of Thoracic and Cardiovascular Surgery, 2004
- Endovascular Edge-to-Edge Mitral Valve RepairCirculation, 2003
- On the mechanism of functional mitral regurgitationThe American Journal of Cardiology, 1993
- Left ventricular shape is the primary determinant of functional mitral regurgitation in heart failureJournal of the American College of Cardiology, 1992
- Dilated cardiomyopathy with mitral regurgitation: Decreased survival despite a low frequency of left ventricular thrombusAmerican Heart Journal, 1991