The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)
Interventions for valvular disease and heart failure
Extracardiac basal annuloplasty for the treatment of secondary mitral regurgitation
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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