Mitral Valve Repair without Cardiopulmonary Bypass or Atriotomy Using the Coapsys Device: Device Design and Implantation Procedure in Canine Functional Mitral Regurgitation Model

Abstract

Background: Myocor developed a unique system, the
Coapsys annuloplasty system, to treat functional mitral
regurgitation (MR) without cardiopulmonary bypass (CPB).
This study was conducted to test the feasibility of the Coapsys
implantation procedure in a canine functional MR model.
Methods: Functional MR with heart failure was induced
in 9 dogs by rapid ventricular pacing (230 beats/min for
30 ± 4 days). The Coapsys device, which consists of anterior
and posterior epicardial pads connected by a subvalvular
chord, was then surgically implanted. Under epicardial
echocardiographic guidance, we placed the Coapsys device
across the left ventricular chamber using the delivery instrument
and needle assembly. We sized the Coapsys device by
drawing the posterior leaflet and annulus toward the anterior
leaflet with the sizing instrument. Final device size was
selected when MR was minimized or eliminated as assessed
by 2-dimensional color Doppler echocardiography.
Results: In all cases, we successfully implanted the Coapsys
device without CPB or atriotomy. MR was reduced an
average of 2 grades. No adverse events, such as hemodynamic
compromise or structural valve damage, were noted.
Conclusion: Coapsys device implantation was feasible
and safe on a beating canine heart. All accessory tools used
for device implantation were found useful.