Related Experiment Video
Updated: Jul 14, 2026
08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
A novel technique for functional mitral regurgitation therapy: mitral annular remodeling
Keiji Kamohara1, Michael Banbury, Anthony Calabro
1Department of Biomedical Engineering, Lerner Research Institute, Cleveland, Ohio, USA.
The Heart Surgery Forum
|June 30, 2007
Summary
A new procedure using substance injection to remodel the mitral annulus successfully reduced functional mitral regurgitation (AIR) in dogs. This off-pump technique shows promise for treating this heart condition.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Biomaterials Science
Background:
- Functional mitral regurgitation (AIR) is a key factor in heart failure progression and mortality.
- A novel mitral annular remodeling technique using peri-annular injection of a nonabsorbable substance was developed.
- This procedure aims to decrease mitral annular dimensions and mitigate functional AIR.
Purpose of the Study:
- To introduce a new surgical procedure for treating functional AIR.
- To evaluate the impact of this procedure on mitral annulus geometry.
- To assess the reduction in the degree of functional AIR.
Main Methods:
- Feasibility was established through seven epicardial injection procedures in a healthy dog model.
- Hemodynamic, angiographic, and echocardiographic assessments were performed.
- Two dogs unexpectedly developed functional AIR and were specifically monitored.
Main Results:
- Successful off-pump injection of a nonabsorbable substance was achieved in all seven dogs without hemodynamic compromise or myocardial ischemia.
- In the two dogs with functional AIR, the septal-lateral dimension reduced from 3.2 cm to 2.6 cm.
- Mitral regurgitation area decreased from 1.2 cm² to 0 cm², with preserved coronary circulation.
Conclusions:
- Off-pump mitral annular remodeling via substance injection is a potential procedural option for functional AIR.
- The technique demonstrated safety and efficacy in reducing mitral annular dimensions and functional AIR in a canine model.
- Further investigation is warranted to explore its clinical applicability in human patients.
Related Concept Videos
01:25Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
01:28Mitral Regurgitation IV: Nursing Management
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...