TY - JOUR AU - Kamohara, Keiji AU - Banbury, Michael AU - Calabro, Anthony AU - Popovi?, Zoran B. AU - Darr, Aniq AU - Ootaki, Yoshio AU - Akiyama, Masatoshi AU - Cingoz, Faruk AU - Ootaki, Chiyo AU - Kopcak, Michael W. AU - Dessoffy, Raymond AU - Liu, Jenny AU - Fukamachi, Kiyotaka PY - 2006/11/08 Y2 - 2024/03/28 TI - A Novel Technique for Functional Mitral Regurgitation Therapy: Mitral Annular Remodeling JF - The Heart Surgery Forum JA - HSF VL - 9 IS - 6 SE - DO - 10.1532/HSF98.20061075 UR - https://journal.hsforum.com/index.php/HSF/article/view/505 SP - E888-E892 AB - <p><b>Background</b>. Functional mitral regurgitation (AIR) plays a pivotal role in the pathophysiology of congestive heart failure, a major cause of cardiac morbidity and mortality. We have developed a mitral annular remodeling procedure through injection of a nonabsorbable substance into the peri-annular tissue of the posterior mitral annulus to reduce the mitral annular dimension in the septal-lateral axis. The purpose of this study is to describe a novel procedure for treatment of functional AIR and report its effects on the geometry of the mitral annulus and degree of AIR.</p><p><b>Methods</b>. Seven preliminary studies were performed using an epicardial approach in a healthy dog model to establish the feasibility of this injection procedure. Unexpectedly, 2 of 7 healthy dogs had a functional AIR of grade 1 to 2+. In these 2 cases, the hemodynamic, angiographic, and echocar-diographic assessments were conducted.</p><p><b>Results</b>. A nonabsorbable substance injection was successfully performed on a beating heart without instability of hemodynamics or any evidence of myocardial ischemia in all 7 dogs. In the 2 dogs with a functional AIR, it was confirmed that the septal-lateral dimension decreased from 3.2 ± 0.2 to 2.6 ± 0.5 cm and the observed MR was reduced (AIR area from 1.2 ±0.1 to 0 cm<sup>2</sup>) without any adverse effects on hemodynamics or coronary circulation (circumflex artery flow, 36.5 ± 0.4 to 40.5 ± 0.1 mL/min).</p><p><b>Conclusion</b>. Off-pump mitral annular remodeling through substance injection may be one procedural option for treatment of functional AIR.</p> ER -