MitraClip, which reduces regurgitation by pinning together the valve leaflets to create what is known as a double orifice.
One size doesn’t fit all, though, given the heterogeneity of mitral valve disease, Francesco Maisano, MD, of San Raffaele Hospital in Milan, explained at the Tech-Con session.
He cited other repair technologies that target the mitral valve chords or leaflets in different ways, such as Neochord, Mitral spacer, and radiofrequency leaflet modification.
Outcomes with those devices have been debatable, given the high bar set by mitral valve surgery, Maisano noted.
What’s really needed are devices that can replicate the annuloplasty ring often used for surgical mitral repair to pull the leaflets closer, he suggested.
One version being developed is a percutaneously implanted surgical ring, called Cardioband, that can be fine tuned in place with an adjustment tool.
Another device, the Carillon Mitral Contour System, with similar function but implanted inside the adjacent coronary sinus was reported to cut down on both regurgitation and heart failure symptoms over 2 years of follow-up.
“This is what is going to be the next step,” Maisano said. “Once percutaneous annuloplasty will become available, I predict that it will be a step toward fully percutaneous mitral repair and this would really hold potential for challenging surgical outcomes.”
Bavaria reported equity interest in CardiAQ Valve Technologies and research grant funds from Edwards Lifesciences, Vascutek, and W.L. Gore.
Maisano reported consultant or advisory board relationships with Medtronic, St. Jude Medical, Abbott Laboratories, and Valtech Surgical Imaging as well as ownership interest in 4Tech.
Primary source: Society of Thoracic Surgeons
Source reference:
Maisano F, Bavaria JE “The next wave of percutaneous therapy” STS 2013.
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Crystal Phend
Staff Writer
Crystal Phend joined MedPage Today in 2006 after roaming conference halls for publications including The Medical Post, Oncology Times, Doctor’s Guide, and the journal IDrugs. When not covering medical meetings, she writes from Silicon Valley, just south of the San Francisco fog.