BIOMECHANICAL PROPERTIES OF HUMAN CORONARY SINUS FOR MINIMALLY INVASIVE MITRAL VALVE REPAIR

摘要

Mitral valve regurgitation, the leakage of blood back to the left atrium during systole, is a significant cause of morbidity and mortality. The current treatment options for symptomatic mitral regurgitation are mitral valve repair and replacement. However, the operative mortality for both of these treatments remains substantial (1). Furthermore, these treatments are often not referred for elderly patients with comorbidities. Thus, there is a pressing need for less invasive, non-surgical treatments of mitral regurgitation. Recently, percutaneous transvenous mitral annuloplasty (PTMA) technique has been investigated as a possible less invasive treatment for mitral regurgitation. The technique, mimicking surgical implantation of an annuloplasty ring, attempts to restore normal mitral valve functions by reducing the size of the mitral annulus. It utilizes the coronary sinus (CS), due to its proximity to the mitral valve, as a pathway for the deployment and implantation of a device that can reduce the diameter of the mitral annulus. Several first-in-human experiences with PTMA devices have showed the feasibility of this technique (1-4), and decreases in mitral annulus diameter and modest reductions of mitral regurgitation grade were obtained. However, device dysfunctions such as failure due to device fracture after several months of implantation or the devices did not provide enough tension for adequate reduction of mitral annulus diameter were reported (1-4).