Transcatheter Mitral Cerclage Annuloplasty
Summary
Functional mitral regurgitation due to annular dilation is associated with morbidity and mortality in patients with dilated cardiomyopathy of any etiology. Transcatheter cerclage mitral annuloplasty (cerclage) is a percutaneous treatment for functional mitral regurgitation that exploits the proximity of the mitral annular plane to the anatomical path of the coronary sinus (CS) in order to surround and compress the mitral annulus. This chapter summarizes the design of a mitral cerclage annuloplasty device and its performance in preclinical and first-inhuman settings. Cerclage addresses several key shortcomings of CS annuloplasty, evident in the early clinical development of devices including Carillon (Cardiac Dimensions), PTMA (Viacor), and MONARC (Edwards Lifesciences). Percutaneous cerclage annuloplasty devices are fairly simple and have three component parts: tension element, wishbone section, and wishbone lock.
