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Early feasibility evaluation of thoracoscopically assisted transcatheter ventricular reconstruction in an experimental model of ischaemic heart failure with left anteroapical aneurysm
Journal article   Peer reviewed

Early feasibility evaluation of thoracoscopically assisted transcatheter ventricular reconstruction in an experimental model of ischaemic heart failure with left anteroapical aneurysm

Yanping Cheng, Geng-Hua Yi, Lon S. Annest, Kevin Van Bladel, Ryan Brown, Andrew Wechsler, Masahiko Shibuya, Gerard B. Conditt, Athanasios Peppas, Greg L. Kaluza, …
EuroIntervention, v 10(12), pp 1480-1487
01 Apr 2015
PMID: 25912393

Abstract

Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology
Aims: To test the feasibility of a thoracoscopically assisted, off-pump, transcatheter ventricular reconstruction (TCVR) approach in an ovine model of left ventricular (LV) anteroapical aneurysm. Methods and results: Myocardial infarction (MI) was induced by coil occlusion of the middle left anterior descending artery and diagonals. Two months after MI creation, TCVR was performed via a minimal thoracotomy in eight sheep. Under endoscopic and fluoroscopic guidance, trans-interventricular septal puncture was performed from the LV epicardial scar. A guidewire was externalised via a snare placed in the right ventricle from the external jugular vein. An internal anchor was inserted over the wire and positioned on the right ventricular septum and an external anchor was deployed on the LV anterior epicardium. Serial pairs of anchors were placed and plicated together to exclude the scar completely. Immediately after TCVR, echo-cardiography showed LV end-systolic volume decreased from pre-procedure 58.8 +/- 16.6 ml to 25.1 +/- 7.6 ml (p<0.01) and the ejection fraction increased from 32.0 +/- 7.3% to 52.0 +/- 7.5% (p<0.01). LV twist significantly improved (3.83 +/- 2.21 vs. pre-procedure -0.41 +/- 0.94, p=0.01) and the global peak-systolic longitudinal strain increased from -5.64% to -10.77% (p<0.05). Conclusions: TCVR using minimally invasive access techniques on the off-pump beating heart is feasible and resulted in significant improvement in LV performance.

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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