Key result
In an ovine model of functional mitral regurgitation, the percutaneous septal sinus shortening system significantly reduced septal-to-lateral diameter and MR grade at 30 days (P=0.01).
Why the study?
Does the percutaneous septal sinus shortening system reduce functional mitral regurgitation in an ovine tachycardia model?
Does the percutaneous septal sinus shortening system reduce functional mitral regurgitation in an ovine tachycardia model?
p-value: p=0.01
The novel percutaneous septal sinus shortening system effectively reduces septal-to-lateral mitral annular diameter and ameliorates functional mitral regurgitation in an ovine model.
Supports device development for functional MR; leaves open human translation of septal sinus shortening.
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<0.001), and MR grade significantly improved (2.1+/-0.6 to 0.4+/-0.4; P<0.001). Despite continued rapid pacing, chronic device implantation resulted in durable SL shortening (30.4+/-1.9 mm before implantation to 25.3+/-0.8 mm at 30 days; 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.
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Rogers et al. (2006) studied Functional mitral regurgitation (n=23). Percutaneous septal sinus shortening system vs. Baseline (before implantation) was evaluated on Septal-to-lateral (SL) mitral annular diameter and MR grade (p=0.01). In an ovine model of functional mitral regurgitation, the percutaneous septal sinus shortening system significantly reduced septal-to-lateral diameter and MR grade at 30 days (P=0.01).
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