Left ventricular restoration devices post myocardial infarction

Hendriks, Tom; Schurer, Remco A. J.; Ali, Lawien Al; Heuvel, Ad F. M. van den; Harst, Pim van der

doi:10.1007/s10741-018-9711-2

Cited by 16 publications

(7 citation statements)

References 81 publications

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“…Каркас АКОР-1 РНЦХ РАМН имеет равную степень растяжимости в обоих направленияхпо длиннику и поперечнику сердца, что обеспечивает более активное участие в сокращении желудочка его верхушки, с которой, собственно, сокращение и начинается. Кроме того, каркас АКОР- ОРИГИНАЛЬНЫЕ СТАТЬИ § ских систем, клеточных технологий [14][15][16][17][18]. Это обстоятельство, наряду с позитивными отдаленными результатами комбинированного («медикаментозная терапия + хирургия») больного М-н, дает основание сделать вывод о целесообразности возобновления экспериментальных и клинических исследований по применению экстракардиального сетчатого каркаса.…”

Section: Discussionunclassified

Mitral valve replacement and implantation of an extracardial mesh frame in patients with severe heart failure: results of a clinical study and a description of a clinical case 18 years after surgery

2021

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Aim Dilated cardiomyopathy (DCMP) is a major cause for severe heart failure. Development of a combination (drug and surgery) treatment of this disease is relevant. This prospective observational study was aimed at evaluating short- and long-term results of extracardiac mesh implantation in DCMP patients with heart failure resistant to the optimum drug therapy.Material and methods The extracardiac mesh ACOR-1 was implanted in 15 patients with DCMP. All meshes were produced individually for each patient and made of Gelweave (great Britain) vascular graft strips. The mesh size corresponded to the heart diastolic size, which was measured after achieving a maximum possible clinical improvement for the patient. Long-term results were followed for up to 4 years. Mean age of patients was 43.1±10.8 years (from 28 to 62 years). One patient was followed up for 18 years. Data of that patient were presented as a clinical case report.Results From October, 2003 through October, 2007, 15 DCMP patients received mesh implants. Cases of in-hospital death were absent. In 3 mos. after the surgery, left ventricular volumes decreased (end-diastolic volume decreased from 251.7±80.7 to 229.0±61.3 ml; end-systolic volume decreased from 182.3±73.6 to 167.7±46.2 ml), and the left ventricular pump function improved (ejection fraction increased from 25.2±6.0 to 27.1±5.1 %; cardiac index increased from 2.0±0.5 to 2.4±0.7 ml /min /m2). The functional state of patients improved by one NYHA class, from 3.7±0.3 to 2.8±0.6. In some cases, the left ventricular size and the systolic function completely normalized. There were no episodes of circulatory decompensation in the long term after surgery. Actuarial survival for the observation period was 100%.Conclusion Implantation of extracardiac mesh prevented progression of heart dilatation and, in combination with drug therapy, it may represent an effective method for treatment of DCMP.

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Section: Discussionunclassified

Mitral valve replacement and implantation of an extracardial mesh frame in patients with severe heart failure: results of a clinical study and a description of a clinical case 18 years after surgery

2021

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“…While the first-in-human study (PARACHUTE) in patients with HFrEF (EF 15–40% and an akinetic of dyskinetic apex) showed safety and feasibility, at 3-year follow-up, a reduction in stroke volume and LVEF were noted. This device was subsequently tested in a randomized, controlled trial (PARACHUTE IV) that enrolled 331 subjects with NYHA class III-IV ischemic cardiomyopathy and wall motion abnormalities (EF 15–35%) with suitable anatomy for the device, however, the trial was terminated prematurely in 2017 and this device is not in use currently ( 86 ). Another device designed to help restore the dysfunctional geometry in a failing ventricle is the AccuCinch ® (Ancora Heart Inc.) Ventricular Restoration System– a nitinol anchor-based cinching cable positioned in the LV cavity below the mitral valve through a retrograde transventricular approach.…”

Section: Ventricular Restorative Devicesmentioning

confidence: 99%

Restructuring the Heart From Failure to Success: Role of Structural Interventions in the Realm of Heart Failure

Kir

Munagala

2022

Front. Cardiovasc. Med.

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Heart failure through the spectrum of reduced (HFrEF), mid-range (or mildly reduced or HFmEF), and preserved ejection fraction (HFpEF), continues to plague patients' quality of life through recurrent admissions and high mortality rates. Despite tremendous innovation in medical therapy, patients continue to experience refractory congestive symptoms due to adverse left ventricular remodeling, significant functional mitral regurgitation (FMR), and right-sided failure symptoms due to significant functional tricuspid regurgitation (FTR). As most of these patients are surgically challenging for open cardiac surgery, the past decade has seen the development and evolution of different percutaneous structural interventions targeted at improving FMR and FTR. There is renewed interest in the sphere of left ventricular restorative devices to effect reverse remodeling and thereby improve effective stroke volume and patient outcomes. For patients suffering from HFpEF, there is still a paucity of disease-modifying effective medical therapies, and these patients continue to have recurrent heart failure exacerbations due to impaired left ventricular relaxation and high filling pressures. Structural therapies involving the implantation of inter-atrial shunt devices to decrease left atrial pressure and the development of implantable devices in the pulmonary artery for real-time hemodynamic monitoring would help redefine treatment and outcomes for patients with HFpEF. Lastly, there is pre-clinical data supportive of soft robotic cardiac sleeves that serve to improve cardiac function, can assist contraction as well as relaxation of the heart, and have the potential to be customized for each patient. In this review, we focus on the role of structural interventions in heart failure as it stands in current clinical practice, evaluate the evidence amassed so far, and review promising structural therapies that may transform the future of heart failure management.

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“…As described earlier, HF patients are typically characterized by ejection fraction (i.e., their symptoms), but there are multiple underlying conditions that cause HF. For example, non-genetic HF can be initiated by myocardial injury (e.g., myocardial infarction) ( 16 ), valvular disease ( 17 ), or as a side effect of some chemotherapies ( 18 ). There are also several forms of genetic heart disease that can lead to heart failure ( 19 – 22 ).…”

Section: Current Challenges In Modeling Human Heart Diseasesmentioning

confidence: 99%

Genetic and Tissue Engineering Approaches to Modeling the Mechanics of Human Heart Failure for Drug Discovery

Greenberg

Daily

Wang

et al. 2018

Front. Cardiovasc. Med.

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Heart failure is the leading cause of death in the western world and as such, there is a great need for new therapies. Heart failure has a variable presentation in patients and a complex etiology; however, it is fundamentally a condition that affects the mechanics of cardiac contraction, preventing the heart from generating sufficient cardiac output under normal operating pressures. One of the major issues hindering the development of new therapies has been difficulties in developing appropriate in vitro model systems of human heart failure that recapitulate the essential changes in cardiac mechanics seen in the disease. Recent advances in stem cell technologies, genetic engineering, and tissue engineering have the potential to revolutionize our ability to model and study heart failure in vitro. Here, we review how these technologies are being applied to develop personalized models of heart failure and discover novel therapeutics.

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Left ventricular restoration devices post myocardial infarction

Cited by 16 publications

References 81 publications

Mitral valve replacement and implantation of an extracardial mesh frame in patients with severe heart failure: results of a clinical study and a description of a clinical case 18 years after surgery

Mitral valve replacement and implantation of an extracardial mesh frame in patients with severe heart failure: results of a clinical study and a description of a clinical case 18 years after surgery

Restructuring the Heart From Failure to Success: Role of Structural Interventions in the Realm of Heart Failure

Genetic and Tissue Engineering Approaches to Modeling the Mechanics of Human Heart Failure for Drug Discovery

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