Effect of Transcatheter Mitral Annuloplasty With the Cardioband Device on 3-Dimensional Geometry of the Mitral Annulus

This study was performed to assess the acute intraprocedural effects of transcatheter direct mitral annuloplasty using the Cardioband device on 3-dimensional (3D) anatomy of the mitral annulus. Of 45 patients with functional mitral regurgitation (MR) enrolled in a single arm, multicenter, prospective trial, 22 had complete pre- and post-implant 3D transesophageal echocardiography (TEE) images stored in native data format that allowed off-line 3D reconstruction. Images with the highest volume rate and best image quality were selected for analysis. Multiple measurements of annular geometry were compared from baseline to post-implant using paired t tests with Bonferroni correction to account for multiple comparisons. The device was successfully implanted in all patients, and MR was reduced to moderate in 2 patients, mild in 17 patients, and trace in 3 patients after final device cinching. Compared with preprocedural TEE, postprocedural TEE showed statistically significantly reductions in annular circumference (137 +/- 15 vs 128 +/- 17 mm; p = 0.042), intercommissural distance (42.4 +/- 4.3 vs 38.6 +/- 4.4 mm; p = 0.029), anteroposterior distance (40.9 +/- 5.4 vs 37.0 +/- 5.7 mm; p = 0.025), and aortic-mitral angle (117 +/- 8 degrees vs 112 +/- 8 degrees; p = 0.032). This study demonstrates that transcatheter direct mitral annuloplasty with the Cardioband device results in acute remodeling of the mitral annulus with successful reduction of functional MR. (C) 2016 Elsevier Inc. All rights reserved