What question did this study set out to answer?

To determine whether papillary muscle repositioning via an external patch device provides persistent reduction of ischemic mitral regurgitation despite potential ongoing left ventricular remodeling.

September 10, 2007Circulation

Persistent Reduction of Ischemic Mitral Regurgitation by Papillary Muscle Repositioning

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Why the study?

Does papillary muscle repositioning using an epicardial patch device reduce ischemic mitral regurgitation in a sheep model of chronic ischemic posterior infarct?

Population

7 sheep with a chronic ischemic posterior infarct model producing LV dilatation and moderate ischemic mitral…

Comparison

Papillary muscle repositioning using an… vs Baseline (pre-patch application)

Design

Preclinical

Follow-up

8 weeks

Authors

JHJudy HungCardiac Imaging MCMiguel ChaputUniversité de Montréal JGJorge GuerreroArkansas Children's Hospital

Discussion

Member takes

Implication

Patch application durably resolves moderate IMR in ovine infarct model without LVEF loss; leaves open translation to human device therapy.

Key Points

To determine whether papillary muscle repositioning via an external patch device provides persistent reduction of ischemic mitral regurgitation despite potential ongoing left ventricular remodeling.
Utilized a chronic posterior myocardial infarction ovine model (N=7) that developed left ventricular dilatation and mitral regurgitation over 10 weeks.
Implanted and adjusted an epicardial patch device under echocardiographic guidance to reposition the papillary muscle, with 8 weeks of post-intervention follow-up evaluated by 3D echocardiography and sonomicrometry.
Acute patch application resolved moderate mitral regurgitation, reducing proximal jet width from 6.5 ± 1.8 mm to 0.6 ± 1.3 mm (P < 0.001) without lowering left ventricular ejection fraction (43 ± 3% vs 44 ± 8%).
Mitral regurgitation reduction was maintained at 8 weeks post-procedure (0.6 ± 1.3 mm vs 1.0 ± 1.0 mm, P=NS), even in animals exhibiting post-infarct left ventricular volume expansion.
Left ventricular contractility and relaxation indices, including end-systolic elastance, dP/dt, and stiffness constants, showed no significant deterioration from acute to chronic follow-up.

Structured PICO

Does papillary muscle repositioning using an epicardial patch device reduce ischemic mitral regurgitation in a sheep model of chronic ischemic posterior infarct?

Population

7 sheep with a chronic ischemic posterior infarct model producing LV dilatation and moderate ischemic mitral regurgitation over 10 weeks

Intervention

Papillary muscle repositioning using an epicardial patch device adjusted under echo guidance

Comparator

Baseline (pre-patch application)

Outcome

Reduction in ischemic mitral regurgitation (measured by proximal jet width) at 8 weeks follow-upsurrogate

Papillary muscle repositioning with an epicardial patch device persistently reduces moderate chronic ischemic mitral regurgitation in a sheep model, even with continued LV remodeling.

Cite This Study

Hung et al. (2007) studied this question.

synapsesocial.com/papers/6a7249d035aa2c282ce32e0a https://doi.org/10.1161/circulationaha.106.679951

Topics

Mitral valve intervention

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Implication

Patch application durably resolves moderate IMR in ovine infarct model without LVEF loss; leaves open translation to human device therapy.

Persistent Reduction of Ischemic Mitral Regurgitation by Papillary Muscle Repositioning

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Persistent Reduction of Ischemic Mitral Regurgitation by Papillary Muscle Repositioning

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider