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Mechanical Effects of Cardiovascular Drugs and Devices
Published in Michel R. Labrosse, Cardiovascular Mechanics, 2018
An annuloplasty ring is a rigid or flexible ring implanted around the mitral or tricuspid heart valve for reconstructive treatment of valvular insufficiency. The ring is sutured to the annular tissue to reshape, reinforce, and tighten the valve; this enables more complete leaflet closure. The stiff ring alters annular biomechanics, reducing the ability of the annulus to change size, which can lead to lower cardiac outputs. Valve repair with annuloplasty rings does not usually require long-term anticoagulant therapy, but short-term complications common with all cardiac surgery occur; therefore, it requires careful monitoring and appropriate physician training.
Catheterization of the cardiac venous system
Published in Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead, Cardiovascular Catheterization and Intervention, 2017
Amartya Kundu, Chirag Bavishi, Partha Sardar, Saurav Chatterjee
The purpose of mitral annuloplasty is to treat functional mitral regurgitation secondary to dilated cardiomyopathy via a percutaneous approach, thereby avoiding the risks of open surgery. This is possible because of the proximity of the CS to the mitral valve annulus. The procedure mimics surgical annuloplasty by shortening the anterior-posterior dimensions of the mitral annulus.
Intradiscal Therapies
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
Vijay Singh, Laxmaiah Manchikanti
The indications for the use of these annuloplasty techniques are similar to those for other intradiscal therapies. Understanding the pathomechanisms of discogenic pain whether from internal disc disruption or from a small contained disc herniation with or without internal disc disruption is vital to a successful outcome.
Devices for transcatheter mitral valve repair: current technology and a glimpse into the future
Published in Expert Review of Medical Devices, 2021
Daniel Perez-Camargo, Mi Chen, Maurizio Taramasso
The experience with edge-to-edge therapy in secondary MR will guide the path to a large number of devices in early stages of development and will provide more knowledge into the pathophysiology, natural history, and outcomes of this entity, the MATTERHORN trial will compare the MitraClip system against surgical MVr, and outcomes of MitraClip versus optimal medical therapy in moderate FMR will be addressed in the EVOLVE-MR trial [118]. Annuloplasty devices have proved safety and efficacy in this setting, and the ongoing ACTIVE trial will compare Cardioband versus optimal medical therapy. The results of trials evaluating LV remodeling devices (CORCINCH-HF, VenTouch OUS) are long awaited and, as with primary MR, feasibility of a combined approach has been described [63,66]. Moreover, new applications of TMVr in the context of advanced HF such as the RESHAPE-HF 2, or as a bridge to heart transplantation (MitraBridge) and cardiogenic shock (Mitra-Shock) could provide new indications in this population [50,52].
Tricuspid regurgitation: when is it time for surgery?
Published in Expert Review of Cardiovascular Therapy, 2021
Ana Paula Tagliari, Daniel Perez-Camargo, Maurizio Taramasso
The concept of a prosthetic ring to reinforce the tricuspid annulus was first introduced by Carpentier in 1971 [66]. Annuloplasty rings have several technical advantages over suture annuloplasty, including better tension distribution in the annuloplasty suture line, more standardized annular reduction, and the ability to differentially plicate an asymmetrically dilated annulus. Furthermore, ring annuloplasty is easier to master and more reproducible, resulting in less residual or recurrent TR than suture techniques [61]. The ring’s size is generally chosen by measuring the distance from the anteroseptal to the posteroseptal commissures. The ring is implanted using eight to ten 2–0 stitches starting posteriorly (at the midpoint of the septal leaflet) and, then, proceeding counterclockwise (Figure 4(e–h)).
Surgical Versus Percutaneous Approaches for Degenerative Mitral Valve Repair: A Review
Published in Structural Heart, 2019
Farhang Yazdchi, Tsuyoshi Kaneko, Gilbert H. L. Tang
Data on transcatheter annuloplasty technology remains scarce and preliminary. Several transcatheter devices for direct or indirect (via coronary sinus) annuloplasty have been developed.29 Although these devices were mainly used for secondary MR which is not the focus of this review, here we briefly summarize them because of the importance of the annuloplasty technique in surgical mitral valve repair. The Cardioband™ (Edwards LifeSciences LLC, Irvine, CA, USA) (Figure 4D) is a percutaneous, direct band annuloplasty anchored on the posterior mitral annulus via a transseptal approach. A polyester sleeve with radiopaque markers is implanted from commissure to commissure by multiple anchors. Once accomplished, MR reduction can be achieved by cinching the band to reduce mitral annular dimensions. The Cardioband received the CE mark in September 2015 based on a European prospective multicenter study that established the safety, durability of MR reduction, and improved quality of life and exercise capacity.57 A study to evaluate its safety and efficacy in patients with functional MR is planned in the United States—the Annular ReduCtion for Transcatheter Treatment of Insufficient Mitral ValvE (ACTIVE) Trial (NCT03016975). The Millipede IRIS (Boston Scientific, Marlborough, MA, USA) is also a percutaneous annuloplasty repair system but it is a complete and semi-rigid ring. The device, guided by TEE and intracardiac echocardiography, recently completed a successful first-in-human clinical study with promising results.58