Transcatheter Mitral Annuloplasty in Chronic Functional Mitral Regurgitation 6-Month Results With the Cardioband Percutaneous Mitral Repair System

被引:110
|
作者
Nickenig, Georg [1 ]
Hammerstingl, Christoph [1 ]
Schueler, Robert [1 ]
Topilsky, Yan [2 ]
Grayburn, Paul A. [3 ]
Vahanian, Alec [4 ]
Messika-Zeitoun, David [4 ]
Alcazar, Marina Urena [4 ]
Baldus, Stephan [5 ]
Volker, Rudolph [5 ]
Huntgeburth, Michael [5 ]
Alfieri, Ottavio [6 ]
Latib, Azeem [6 ]
La Canna, Giovanni [6 ]
Agricola, Eustachio [6 ]
Colombo, Antonio [7 ,8 ]
Kuck, Karl-Heinz [9 ]
Kreidel, Felix [9 ]
Frerker, Christian [9 ]
Tanner, Felix C. [10 ]
Ben-Yehuda, Ori [11 ,12 ]
Maisano, Francesco [10 ]
机构
[1] Univ Hosp Bonn, Heart Ctr Bonn, Dept Cardiol, Sigmund Freud Str 25, D-53105 Bonn, Germany
[2] Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel
[3] Baylor Hlth, Dallas, TX USA
[4] Univ Paris 07, Bichat Claude Bernard Hosp, Paris, France
[5] Univ Cologne, Ctr Heart, Cologne, Germany
[6] San Raffaele Univ Hosp, Milan, Italy
[7] EMO GVM Ctr Cuore Columbus, Intervent Cardiol Unit, Milan, Italy
[8] Ist Sci San Raffaele, Intervent Cardiol Unit, Milan, Italy
[9] Asklepios Klin St Georg Hosp, Dept Cardiol, Hamburg, Germany
[10] Univ Zurich Hosp, Univ Heart Ctr, Valve Clin, Zurich, Switzerland
[11] Cardiovasc Res Fdn, New York, NY USA
[12] Columbia Univ, New York, NY USA
关键词
direct annuloplasty; functional mitral regurgitation; heart failure; transcatheter mitral repair; TO-EDGE REPAIR; HEART-FAILURE; PROGNOSIS; SURGERY;
D O I
10.1016/j.jcin.2016.07.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES This study sought to show safety and efficacy of the Cardioband system during 6 months after treatment. BACKGROUND Current surgical and medical treatment options for functional mitral regurgitation (FMR) are limited. The Cardioband system (Valtech Cardio, OrYehuda, Israel) is a novel transvenous, transseptal direct annuloplasty device. METHODS Thirty-one patients (71.8 +/- 6.9 years of age; 83.9% male; EuroSCORE II: 8.6 +/- 5.9) with moderate to severe FMR, symptomatic heart failure, and depressed left ventricular function (left ventricular ejection fraction 34 +/- 11%) were prospectively enrolled. RESULTS Procedural success rate, defined as delivery of the entire device, was 100%. There were no periprocedural deaths (0%), and mortality rate at 1 month or prior to hospital discharge and at 7 months was5% and 9.7% respectively. Cinching of the implanted Cardioband reduced the annular septolateral dimension by >30% from 3.7 +/- 0.5 cm at baseline to 2.5 +/- 0.4 cm after 1 month and to 2.4 +/- 0.4 cm after 6 months, respectively (p<0.001). Percentage of patients with FMR >= 3 was reduced from 77.4% to 10.7% 1 month after the procedure (p < 0.001) and 13.6% (p < 0.001) at 7 months. Percentage of patients with New York Heart Association functional class III/IV decreased from 95.5% to 18.2% after 7 months (p<0.001); exercise capacity as assessed by 6-min walking test increased from 250 +/- 107 m to 332 +/- 118 m (p<0.001) and quality of life (Minnesota Living With Heart Failure Questionnaire) was also significantly improved (p < 0.001). CONCLUSIONS In this feasibility trial in symptomatic patients with FMR, transcatheter mitral annuloplasty with the Cardioband was effective in reducing MR and was associated with improvement in heart failure symptoms and demonstrated a favorable safety profile. (Cardioband With Transfemoral Delivery System; NCT01841554) (C) 2016 by the American College of Cardiology Foundation.
引用
收藏
页码:2039 / 2047
页数:9
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