Novel epicardial off-pump device for mitral regurgitation: acute evaluation

Tohru Takaseya, Akira Shiose, Roberto M. Saraiva, Hideyuki Fumoto, Yoko Arakawa, Mark Juravic, Pierluca Lombardi, Kiyotaka Fukamachi

研究成果: ジャーナルへの寄稿記事

2 引用 (Scopus)

抄録

Objective: This study evaluates the ability of a novel epicardial annuloplasty device Mitral Touch (MAQUET Cardiovascular LLC, San Jose, CA, USA) to reduce functional mitral regurgitation (MR) in a rapid ventricular pacing-induced dilated cardiomyopathy model in dogs. Methods: A median sternotomy was performed in 13 dogs after MR induction by rapid ventricular pacing (230 beats/min for an average of 35.6 ± 12.8 days). Two-dimensional epicardial echocardiographic and haemodynamic measurements were performed to evaluate the baseline MR grade, the septal-lateral (S-L) dimension of the mitral annulus, mitral valve (MV) geometry and left ventricular function. The Mitral Touch was implanted by sliding the anterior arm onto the floor of the transverse sinus and positioning the posterior arm just apical to the atrioventricular groove on the left ventricular posterolateral wall. The 24-mm-long device was implanted in eight dogs, the 27-mm-long device in four and the 30-mm standard length device in one. MR grade, S-L dimension and haemodynamics data acquisition were immediately rechecked after device implantation. Results: All implantations, which took only approximately 30 s to deploy, were performed on beating hearts without cardiopulmonary bypass. In one early case, after extended manipulation with undersized devices, an atrial laceration was created and bleeding occurred. Design changes were made to eliminate this complication. The MR grade was significantly (p = 0.003) reduced from 3.1 ± 1.1 at baseline to 1.4 ± 0.8 after device implantation. The S-L dimension at end of systole was also significantly (p = 0.001) reduced from 2.7 ± 0.4 cm at baseline to 2.3 ± 0.3 cm after device implantation (% reduction: 15.1 ± 10.6%). The mitral valve coaptation length was significantly (p = 0.0001) increased from 0.36 ± 0.11 cm to 0.50 ± 0.08 cm, and the mitral valve tethering area was significantly (p = 0.0003) decreased from 1.36 ± 0.38 cm2 to 0.81 ± 0.29 cm2 after Mitral Touch implantation. Conclusions: This new epicardial device was effective in significantly reducing MR and S-L dimensions acutely on the beating heart without requiring the use of cardiopulmonary bypass. Further studies are necessary to confirm the long-term maintenance of MR and S-L reductions.

元の言語英語
ページ(範囲)1291-1296
ページ数6
ジャーナルEuropean Journal of Cardio-thoracic Surgery
37
発行部数6
DOI
出版物ステータス出版済み - 6 1 2010

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Mitral Valve Insufficiency
Equipment and Supplies
Touch
Mitral Valve
Dogs
Cardiopulmonary Bypass
Hemodynamics
Mitral Valve Annuloplasty
Transverse Sinuses
Aptitude
Sternotomy
Lacerations
Systole
Dilated Cardiomyopathy
Left Ventricular Function
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

これを引用

Takaseya, T., Shiose, A., Saraiva, R. M., Fumoto, H., Arakawa, Y., Juravic, M., ... Fukamachi, K. (2010). Novel epicardial off-pump device for mitral regurgitation: acute evaluation. European Journal of Cardio-thoracic Surgery, 37(6), 1291-1296. https://doi.org/10.1016/j.ejcts.2009.11.054

Novel epicardial off-pump device for mitral regurgitation : acute evaluation. / Takaseya, Tohru; Shiose, Akira; Saraiva, Roberto M.; Fumoto, Hideyuki; Arakawa, Yoko; Juravic, Mark; Lombardi, Pierluca; Fukamachi, Kiyotaka.

:: European Journal of Cardio-thoracic Surgery, 巻 37, 番号 6, 01.06.2010, p. 1291-1296.

研究成果: ジャーナルへの寄稿記事

Takaseya, T, Shiose, A, Saraiva, RM, Fumoto, H, Arakawa, Y, Juravic, M, Lombardi, P & Fukamachi, K 2010, 'Novel epicardial off-pump device for mitral regurgitation: acute evaluation', European Journal of Cardio-thoracic Surgery, 巻. 37, 番号 6, pp. 1291-1296. https://doi.org/10.1016/j.ejcts.2009.11.054
Takaseya, Tohru ; Shiose, Akira ; Saraiva, Roberto M. ; Fumoto, Hideyuki ; Arakawa, Yoko ; Juravic, Mark ; Lombardi, Pierluca ; Fukamachi, Kiyotaka. / Novel epicardial off-pump device for mitral regurgitation : acute evaluation. :: European Journal of Cardio-thoracic Surgery. 2010 ; 巻 37, 番号 6. pp. 1291-1296.
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AU - Takaseya, Tohru

AU - Shiose, Akira

AU - Saraiva, Roberto M.

AU - Fumoto, Hideyuki

AU - Arakawa, Yoko

AU - Juravic, Mark

AU - Lombardi, Pierluca

AU - Fukamachi, Kiyotaka

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N2 - Objective: This study evaluates the ability of a novel epicardial annuloplasty device Mitral Touch (MAQUET Cardiovascular LLC, San Jose, CA, USA) to reduce functional mitral regurgitation (MR) in a rapid ventricular pacing-induced dilated cardiomyopathy model in dogs. Methods: A median sternotomy was performed in 13 dogs after MR induction by rapid ventricular pacing (230 beats/min for an average of 35.6 ± 12.8 days). Two-dimensional epicardial echocardiographic and haemodynamic measurements were performed to evaluate the baseline MR grade, the septal-lateral (S-L) dimension of the mitral annulus, mitral valve (MV) geometry and left ventricular function. The Mitral Touch was implanted by sliding the anterior arm onto the floor of the transverse sinus and positioning the posterior arm just apical to the atrioventricular groove on the left ventricular posterolateral wall. The 24-mm-long device was implanted in eight dogs, the 27-mm-long device in four and the 30-mm standard length device in one. MR grade, S-L dimension and haemodynamics data acquisition were immediately rechecked after device implantation. Results: All implantations, which took only approximately 30 s to deploy, were performed on beating hearts without cardiopulmonary bypass. In one early case, after extended manipulation with undersized devices, an atrial laceration was created and bleeding occurred. Design changes were made to eliminate this complication. The MR grade was significantly (p = 0.003) reduced from 3.1 ± 1.1 at baseline to 1.4 ± 0.8 after device implantation. The S-L dimension at end of systole was also significantly (p = 0.001) reduced from 2.7 ± 0.4 cm at baseline to 2.3 ± 0.3 cm after device implantation (% reduction: 15.1 ± 10.6%). The mitral valve coaptation length was significantly (p = 0.0001) increased from 0.36 ± 0.11 cm to 0.50 ± 0.08 cm, and the mitral valve tethering area was significantly (p = 0.0003) decreased from 1.36 ± 0.38 cm2 to 0.81 ± 0.29 cm2 after Mitral Touch implantation. Conclusions: This new epicardial device was effective in significantly reducing MR and S-L dimensions acutely on the beating heart without requiring the use of cardiopulmonary bypass. Further studies are necessary to confirm the long-term maintenance of MR and S-L reductions.

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