HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Yoshio Ootaki Patrick M. McCarthy Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fukamachi, K. Articles by McCarthy, P. M. Search for Related Content PubMed PubMed Citation Articles by Fukamachi, K. Articles by McCarthy, P. M. Related Collections Valve disease

Eur J Cardiothorac Surg 2004;25:352-357
© 2004 Elsevier Science NL

Changes in mitral annular and left ventricular dimensions and left ventricular pressure–volume relations after off-pump treatment of mitral regurgitation with the Coapsys device

Kiyotaka Fukamachi^a*, Zoran B. Popovi^b, Masahiro Inoue^a, Kazuyoshi Doi^a, Soren Schenk^a, Yoshio Ootaki^a, Michael W. Kopcak, Jr.^a, Patrick M. McCarthy^a,c

^a Department of Biomedical Engineering/ND 20, Lerner Research Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
^b Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
^c Department of Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA

Received 14 October 2003; accepted 3 December 2003.

^* Corresponding author. Tel.: +1-216-445-9344; fax: +1-216-444-9198
e-mail: fukamach{at}bme.ri.ccf.org

Objective: The objective of this study was to evaluate the changes in mitral annular and left ventricular dimensions and left ventricular pressure–volume relations produced by the Myocor Coapsys device that has been developed to treat functional mitral regurgitation (MR) off-pump. Methods: The Coapsys device, which consists of anterior and posterior epicardial pads connected by a sub-valvular chord, was implanted in seven dogs with functional MR resulting from pacing induced cardiomyopathy. The Coapsys device was then sized by drawing the posterior leaflet and annulus toward the anterior leaflet. During sizing, MR grade was assessed using color flow Doppler echocardiography. Final device size was selected when MR was eliminated or minimized. Following implantation, heart failure was maintained by continued pacing for a period of 8 weeks. Mitral annular and left ventricular dimensions and left ventricular pressure–volume relations were evaluated by two-dimensional echocardiography and a conductance catheter, respectively, at pre-sizing, post-sizing, and after 8 weeks. Results: All implants were performed on beating hearts without cardiopulmonary bypass. Mean MR grade was reduced from 2.9±0.7 at pre-sizing to 0.7±0.8 at post-sizing (P<0.001), and was maintained at 0.8±0.8 after 8 weeks (P<0.01). The septal–lateral dimensions were significantly reduced at both mitral annular level [2.4±0.2 cm at pre-sizing, 1.5±0.3 cm at post-sizing (P<0.001), and 1.8±0.3 cm after 8 weeks (P<0.05)] and mid-papillary level [4.1±0.4 cm at pre-sizing, 2.4±0.2 cm at post-sizing (P<0.001), and 3.3±0.4 cm after 8 weeks (P<0.001)]. The end-systolic pressure–volume relation shifted leftward at post-sizing with a significantly steeper slope (P=0.03). There was a significant (P=0.03) leftward shift of the end-diastolic pressure–volume relation at post-sizing. After 8 weeks, these changes in pressure–volume relations tended to return to pre-sizing relations. Conclusions: The Coapsys device significantly reduced MR by treating both the mitral annular dilatation and the papillary muscle displacement. Despite these significant dimensional changes, the Coapsys device did not negatively affect the left ventricular pressure–volume relations.

Key Words: Beating heart • Heart valves • Mitral valve repair • Off-pump

This article has been cited by other articles:

				M. Flynn, R. Curtin, E. R. Nowicki, J. Rajeswaran, S. D. Flamm, E. H. Blackstone, and T. Mihaljevic Regional wall motion abnormalities and scarring in severe functional ischemic mitral regurgitation: A pilot cardiovascular magnetic resonance imaging study. J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1063 - 70.e2. [Abstract] [Full Text] [PDF]

				E.A. Grossi, Y.J. Woo, C.F. Schwartz, D.M. Gangahar, V.A. Subramanian, N. Patel, J. Wudel, P.L. DiGiorgi, A. Singh, and R.D. Davis Comparison of Coapsys annuloplasty and internal reduction mitral annuloplasty in the randomized treatment of functional ischemic mitral regurgitation: Impact on the left ventricle J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1095 - 1098. [Abstract] [Full Text] [PDF]

				Y. K. Mishra, S. Mittal, P. Jaguri, and N. Trehan Coapsys Mitral Annuloplasty for Chronic Functional Ischemic Mitral Regurgitation: 1-Year Results Ann. Thorac. Surg., January 1, 2006; 81(1): 42 - 46. [Abstract] [Full Text] [PDF]

				E. A. Grossi, P. C. Saunders, Y. J. Woo, D. M. Gangahar, J. C. Laschinger, D. C. Kress, M. P. Caskey, C. F. Schwartz, and J. Wudel Intraoperative Effects of the Coapsys Annuloplasty System in a Randomized Evaluation (RESTOR-MV) of Functional Ischemic Mitral Regurgitation Ann. Thorac. Surg., November 1, 2005; 80(5): 1706 - 1711. [Abstract] [Full Text] [PDF]

				F. A. Tibayan, F. Rodriguez, F. Langer, M. K. Zasio, L. Bailey, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Annular or subvalvular approach to chronic ischemic mitral regurgitation? J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1266 - 1275. [Abstract] [Full Text] [PDF]