Extracardiac basal annuloplasty for the treatment of secondary mitral regurgitation

DOI: 10.4244/EIJ-D-22-00363

Jérémy Bernard
Jérémy Bernard1, MSc; Erwan Salaun1, MD, PhD; Chandrasekar Padmanabhan2, MD; Marek Deja3, MD, PhD; Milind Hote4, MD; Shiv Kumar Choudhary4, MD; Jan Hlavička5, MD, PhD; Richard Saldanha6, MD; Radim Brát7, MD, PhD; Anil Jain8, MS; Naman Shastri9, MD; Seetharam Bhat10, MD; Chandana NC10, MD; Manoj Durairaj11, MD; Bikash Rai Das12, MD; Anil Kumar Agarwal13, MD; Vivek Rao14, MD; Krishna Talluri15, MD; Jonathan Beaudoin1, MD; Mathieu Bernier1, MD; Nancy Côté1, PhD; Jaishankar Raman16, MD, PhD; Philippe Pibarot1, DVM, PhD
1. Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval/Québec Heart & Lung Institute, Québec City, Québec, Canada; 2. G. Kuppuswamy Naidu Memorial Hospital, Coimabatore, India; 3. Medical University of Silesia, Katowice, Poland; 4. All India Institute of Medical Sciences, New Delhi, India; 5. University Hospital Kralovske Vinohrady, Prague, Czech Republic; 6. K.L.E.S. Dr Prabhakar Kore Hospital & MRC, Belagavi, India; 7. Department of Cardiac Surgery, University Hospital Ostrava, Ostrava, Czech Republic; 8. EPIC Hospital (Unit of Vatsalya Healthcare LLP), Ahmedabad, India; 9. SAL Hospital, Ahmedabad, India; 10. Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India; 11. Ruby Hall Clinic, Pune, India; 12. GNRC Hospital, Guwahati, India; 13. Maharaja Agrasen Hospital, New Delhi, India; 14. Toronto General Hospital, Toronto, ON, Canada; 15. Phoenix Cardiac Devices, Inc., Cary, NC, USA; 16. Austin Hospital and St Vincent’s Hospital, University of Melbourne, Melbourne, Australia
Introduction Among the 24 million people affected worldwide by mitral regurgitation1, almost two-thirds suffer from secondary mitral regurgitation (SMR)2. Moreover, the presence of symptomatic SMR in patients with heart failure (HF) remains a marker of increased mortality and rehospitalisation risk whatever its severity2. Thus, recent guidelines recommend downsized mitral annuloplasty as a standalone procedure (Class IIb) or as a concomitant procedure combined with coronary artery bypass grafting (CABG; Class I in European and IIa in American guidelines) for the management of SMR34. However, standard annuloplasty remains an intracardiac procedure requiring aortic cross-clamping and cardiopulmonary bypass and is thus associated with an ...

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