Mitral loop cerclage as a variant form of mitral cerclage annuloplasty that adds a device (CSTV) for preventing potential complications: a preclinical proof of concept and feasibility study

Abstract

MLC, as a novel approach for catheter-based mitral valve repair, appeared feasible in this short-term preclinical model. Further studies with longer follow-up in a cardiomyopathic animal model are needed to verify the clinical feasibility and safety of MLC.

Mitral Loop Cerclage Annuloplasty for Secondary Mitral Regurgitation

“…The purpose-built mitral loop cerclage catheter system (Tau-PNU Medical Co, Ltd, Pusan, Korea) has been described previously and has 4 implanted components (Figure 1) (10). One is a cerclage tension element made of stainless steel (previously described as a “cerclage rope”).…”

“…To address these limitations, we developed transcatheter mitral cerclage annuloplasty, which incorporates an arch-like device to protect entrapped coronary arteries against compression, which delivers circumferential annular tension that enhances leaflet coaptation irrespective of rotational orientation of the mitral commissure in relation to the coronary sinus, and which accomplishes septal-lateral apposition irrespective of high atrial variants of the coronary sinus (9). Thereafter, we reported preclinical results of a new “mitral loop cerclage” catheter system (10). Herein we report the results of the first human test of mitral loop cerclage.…”

Computational analysis of the electromechanical performance of mitral valve cerclage annuloplasty using a patient-specific ventricular model

“…Since the MVCA technique avoids the clinical risks of the open-heart procedure, this method is less invasive, less risky and more accessible than conventional mitral valve annuloplasty. This procedure tightens the mitral annular circumference, inspired from epicardial purse-string annuloplasty [23]. Patients treated by this tightening procedure benefit from the stress unloading effect in their ventricular muscles, which ultimately reduces the size of the ventricles.…”

“…Patients treated by this tightening procedure benefit from the stress unloading effect in their ventricular muscles, which ultimately reduces the size of the ventricles. Successful MVCA cases in swine, canine and human were reported previously [234]. However, the clinical outcomes of the MVCA procedure were not satisfactory for some patients [234].…”

“…Successful MVCA cases in swine, canine and human were reported previously [234]. However, the clinical outcomes of the MVCA procedure were not satisfactory for some patients [234]. Moreover, questions concerning the physiological mechanism involved in heart-muscle recovery due to this procedure and how much mitral circumference needs to be tightened depending on the patient remain unanswered.…”