Mitral annular remodeling to treat functional mitral regurgitation: a pilot acute study in a canine model

Heart Surg Forum. 2010 Aug;13(4):E247-50. doi: 10.1532/HSF98.20101003.

Abstract

Background: The aim of this study was to evaluate the feasibility and efficacy of the injection of a nonabsorbable substance into the base of the left ventricle (LV) to treat functional mitral regurgitation (MR).

Methods: Tyramine-based hyaluronan hydrogel was injected into the base of the LV of the beating heart in a canine model of rapid ventricular pacing-induced functional MR (n = 4). The severity of MR was evaluated by epicardial echocardiography before and after hydrogel injection.

Results: The injection improved MR grade from 3.4 +/- 0.8 to 1.3 +/- 0.5 (P = .006) without inducing hemodynamic instability or any evidence of myocardial ischemia. We noted significant decreases in the septal-lateral dimension at the mitral annulus (3.4 +/- 0.4 cm to 2.9 +/- 0.3 cm; P = .039) and MR volume (20.6 +/- 7.3 mm3 to 5.2 +/- 2.2 mm3; P = .044).

Conclusions: A novel treatment consisting of hydrogel injection into the base of the LV between the 2 papillary muscles was found to be feasible and effective for reducing functional MR in a canine model.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Dogs
  • Echocardiography
  • Feasibility Studies
  • Heart Ventricles
  • Hyaluronic Acid / administration & dosage*
  • Hydrogel, Polyethylene Glycol Dimethacrylate / administration & dosage*
  • Injections, Intramuscular
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / physiopathology*
  • Mitral Valve Insufficiency / therapy*
  • Papillary Muscles
  • Pilot Projects
  • Postoperative Period
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Hydrogel, Polyethylene Glycol Dimethacrylate
  • Hyaluronic Acid