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Percutaneous mitral annuloplasty device leaves free access to cardiac veins for resynchronization therapy
Author(s) -
Hoppe Uta C.,
Brandt Mathias C.,
Degen Hubertus,
Dodos Fotini,
Schneider Thorsten,
Stoepel Carsten,
Kroener Axel,
Haude Michael
Publication year - 2009
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22097
Subject(s) - medicine , coronary sinus , cardiology , cardiac resynchronization therapy , great cardiac vein , mitral valve annuloplasty , coronary vein , percutaneous coronary intervention , percutaneous , heart failure , mitral valve , mitral valve repair , ejection fraction , myocardial infarction
Objectives: To assess the feasibility to place a left ventricular lead into the coronary sinus following percutaneous mitral annuloplasty. Background: Percutaneous coronary sinus‐based mitral annuloplasty may reduce functional mitral regurgitation in chronic systolic heart failure. However, concerns have been raised whether the placement of an annular remodeling device in the coronary sinus might preclude subsequent lead placement for resynchronization therapy (CRT). Methods: Three patients with ischemic cardiomyopathy included in the AMADEUS™ trial underwent CRT 7 to 8 months after implantation of a mitral valve annuloplasty device. Results: Fluoroscopy and control coronary angiography revealed a stable position of the annuloplasty device without any compromise of coronary blood flow. Intravascular ultrasound of the coronary sinus excluded any thrombus formation and demonstrated smooth endothelialization of the annular remodeling device. Access of the coronary sinus and placement of the left ventricular lead into a posterolateral cardiac vein was not at all compromised by the mitral valve annuloplasty device in any patient. Conclusions: Positioning a left ventricular pacing lead for CRT is feasible after permanent implantation of a coronary sinus‐based mitral annuloplasty device in patients with dilated cardiomyopathy. © 2009 Wiley‐Liss, Inc.