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New techniques for percutaneous repair of the mitral valve

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Abstract

A variety of innovative techniques and devices are being developed for the percutaneous management of mitral insufficiency. More than 30 devices are in stages of development from early stage to human pivotal trials. Two devices for the management of degenerative myxomatous disease of the mitral valve replicate the Alfieri edge-to-edge surgical repair. One of those devices, the Evalve Mitraclip, is in a pivotal trial at the current time. The other devices address functional mitral regurgitation by a variety of techniques for performing mitral valve annuloplasty. The majority of devices take advantage of the proximity of the coronary sinus to the posterior mitral annulus to deliver devices that remodel the mitral annulus. Two devices perform septal lateral cinching decreasing the anterior posterior diameter of the mitral annulus and correcting leaflet malcoaptation. Numerous issues are discussed including regulatory hurdles and the integration of percutaneous techniques into clinical practice in a safe and efficacious manner.

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References

  1. cvPipeline. www.cvPipeline.com, by MarketMonitors, 3/2006.

  2. Carpentier A, Cardiac valve surgery—the “French connection.” J Thorac Cardiovasc Surg 1983;86:323–37.

    PubMed  CAS  Google Scholar 

  3. Savage EB, Ferguson TB, DiSesa VJ. Use of mitral valve repair: Analysis of contemporary United States experience reported to the Society of Thoracic Surgeons National Cardiac Database. Ann Thorac Surg 2003;75:820–5.

    Article  PubMed  Google Scholar 

  4. STS Database 2005 executive Summary. http://www.sts.org/documents/pdf/STS-ExecutiveSummaryFall2005.pdf. Accessed March 30, 2006.

  5. David TE, Ivanov J, Armstrong S, Christie D, Rakowski H. A comparison of outcomes of mitral valve repair for degenerative disease with posterior, anterior, and bileaflet prolapse. J Thorac Cardiovasc Surg 2005;130(5):1242–9.

    Article  PubMed  Google Scholar 

  6. Alfieri O, Maisano F, De Bonis M, Stefano PL, Torracca L, Oppizzi M, La Canna G. The double-orifice technique in mitral valve repair: A simple solution for complex problems. J Thorac Cardiovasc Surg 2001;122:674–81.

    Article  PubMed  CAS  Google Scholar 

  7. Maisano F, Caldarola A, Blasio A, De Bonis M, La Canna G, Alfieri O. Midterm results of edge-to-edge mitral valve repair without annuloplasty. J Thorac Cardiovasc Surg 2003;126(6):1987–97.

    Article  PubMed  Google Scholar 

  8. Bhudia SK, McCarthy PM, Smedira NG, Lam GK, Rajeswaran J, Blackstone EH. Edge-to-edge (Alfieri) mitral repair: Results in diverse clinical settings. Ann Thorac Surg 2004;77:1598–606.

    Article  PubMed  Google Scholar 

  9. Feldman T, Wasserman HS, Herrmann HC, Gray W, Block PC, Whitlow P, St Goar F, Rodriquez L, Silvestry F, Schwartz A, Sanborn TA, Condado JA, Foster E. Percutaneous mitral valve repair using the edge-to-edge technique: Six-month results of the EVEREST phase I clinical trial. J Am Coll Cardiol 2005;46(11):2134–40.

    Article  PubMed  Google Scholar 

  10. Block PC, Herrmann HC, Whitlow PL, Kramer P, Wasserman HS, Gray WA, Foster E, Feldman T. Percutaneous edge-to-edge mitral valve repair using the Evalve mitraclip: Initial experience with functional mitral regurgitation in the EVEREST I trial. JACC 2006;283A.

  11. Hueb AC, Jatene FB, Moreira LFP, Pomerantzeff PM, Kallas E, de Oliveira SA. Ventricular remodeling and mitral valve modifications in dilated cardiomyopathy: New insights from anatomic study. J Thorac Cardiovasc Surg 2002;124:1216–24.

    Article  PubMed  Google Scholar 

  12. Tibayan FA, Rodriguez F, Zasio MK, Bailey L, Liang D, Daughters GT, Langer F, Ingels NB Jr, Miller DC. Geometric distortions of the mitral valvular-ventricular complex in chronic ischemic mitral regurgitation. Circulation 2003;108(suppl 1):II116–21.

    PubMed  Google Scholar 

  13. Bolling SF, Pagani FD, Deeb GM, Bach DS. Intermediate term outcome of mitral reconstruction in cardiomyopathy. J Thorac Cardiovas Surg 1998;115:381–8.

    Article  CAS  Google Scholar 

  14. Wu AH, Aaronson KD, Bollins SF, Pagani FD, Welch K, Koelling TM. Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunction. J Am Coll Cardiol 2005;45:381–87.

    Article  PubMed  Google Scholar 

  15. Kaye Dm, Byrne M, Alferness C, Power J. Feasibility and short-term efficacy of percutaneous mitral annular reduction for the therapy of hear failure-induced mitral regurgitation. Circulation 2003;108:1795–97.

    Article  PubMed  Google Scholar 

  16. Byrne MJ. Kaye DM, Mathis M, Reuter DG, Alferness CA, Power JM. Percutaneous mitral annular reduction provides continued benefit in an ovine model of dilated cardiomyopathy. Circulation 2004;110:3080–92.

    Google Scholar 

  17. Liddicoat JR, Mac Neill BD, Gillinov AM, Cohn WE, Chin CH, Prado AD, Pandian NG, Oesterle SN. Percutaneous mitral valve repair: A feasibility study in an ovine model of acute ischemic mitral regurgitation. Catheter Cardiovasc Interv 2003;60:410–16.

    Google Scholar 

  18. Timek TA, Lai DT, Tibayan F, Liang D, Duaghters GT, Dagum P, Ingels NB, Miller DC. Septal-lateral annular cinching abolishes acute ischemic mitral regurgitation. J Thorac Cardiovasc Surg 2002;123:881–8.

    Article  PubMed  Google Scholar 

  19. Timek TA, Lai DT, Liang D, Tibayan F, Langer F, Rodriguez F, Daughters GT, Ingels NB, Miller DC. Effects of paracommissural septal-lateral annular cinching on acute ischemic mitral regurgitation. Circulation 2004;110(Suppl II):II79–84.

    PubMed  Google Scholar 

  20. Fukamachi K, Inoue M, Popovic Z, Doi K, Schenk, Nemeh H, Ootaki Y, Kopcak M, Dessoffy R, Thomas J, Bianco R, Berry J, McCarthy P. Off-pump mitral valve repair using the Coapsys Device: A pilot study in pacing-induced mitral regurgitation model. Ann Thorac Surg 2004;77:688–93.

    Article  PubMed  Google Scholar 

  21. Rogers JH, Macoviak JA, Rahdert DA, Takeda PA, Palacios IF, Low RI. Percutaneous septal sinus shortening: A novel procedure for the treatment of functional mitral regurgitation. Circulation 2006;113:2329–2334.

    Article  PubMed  Google Scholar 

  22. Vassiliades TA, Block PC, Cohn LH, Adams DH, Borer JS, Feldman T, Holmes DR, Laskey WK, Lytle BW, Mack MJ, Williams DO. The clinical development of percutaneous heart valve technology. A position statement of the Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), and the Society for Cardiovascular Angiography and Intervention (SCAI). J Am Coll Cardiol 2005;45(9):1554–60.

    Article  PubMed  Google Scholar 

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Correspondence to Michael J. Mack.

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Mack, M.J. New techniques for percutaneous repair of the mitral valve. Heart Fail Rev 11, 259–268 (2006). https://doi.org/10.1007/s10741-006-0104-6

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