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Less invasive ventricular reshaping provides sustained reduction of heart failure symptoms

Session Moderated Poster session 6 - Therapy

Speaker Mauro Biffi

Event : Heart Failure 2017

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Myocardial Disease – Clinical
  • Session type : Moderated Posters

Authors : CS Schmitz (Munich,DE), PN Neuzil (Prague,CZ), IS Skalsky (Prague,CZ), LL Labrousse (Bordeaux,FR), HS Sievert (Frankfurt,DE), CF Frerker (Hamburg,DE), TS Schmidt (Hamburg,DE), KK Kuck (Hamburg,DE), MB Biffi (Bologna,IT), AC Calafiore (Riyadh,SA), DP Pacini (Bologna,IT), RDB Dibartolomeo (Bologna,IT), GD Davidavicius (Vilnius,LT), G Kalinauskas (Vilnius,LT), K Rucinskas (Vilnius,LT)

Authors:
CS Schmitz1 , PN Neuzil2 , IS Skalsky2 , LL Labrousse3 , HS Sievert4 , CF Frerker5 , TS Schmidt5 , KK Kuck5 , MB Biffi6 , AC Calafiore7 , DP Pacini6 , RDB Dibartolomeo6 , GD Davidavicius8 , G Kalinauskas8 , K Rucinskas8 , 1University Hospital of Munich - Munich - Germany , 2Na Homolce Hospital - Prague - Czech Republic , 3Hospital Haut Leveque - Bordeaux-Pessac - France , 4CardioVascular Center Frankfurt - Frankfurt am Main - Germany , 5Asklepios Clinic St. Georg - Hamburg - Germany , 6University of Bologna, Cardiology - Bologna - Italy , 7Prince Sultan Cardiac Center - Riyadh - Saudi Arabia , 8University Hospital Santariskiu Klinikos - Vilnius - Lithuania ,

Citation:
European Journal of Heart Failure ( 2017 ) 19 ( Suppl. S1 ), 529

BACKGROUND. A new technique described as Less Invasive Ventricular Enhancement (LIVE) was performed to reduce and reshape the left ventricle after anteroseptal infarction without cardiopulmonary bypass. Access in the early series was via median sternotomy and later using a hybrid transcatheter approach. We report survival, functional and echocardiographic results at 2 years. METHODS. All patients had MRI or CT demonstrating scars in the anteroseptal wall and symptoms of heart failure NYHA class II/III. Coronary lesions were always treated before the procedure. Significant MR was an exclusion criteria. LIVE was achieved using the Bioventrix Revivent Myocardial Anchoring System. Titanium anchors were delivered to the right side of the interventricular septum. An external anchor was fitted onto a tether to allow apposition of the LV free wall to the scarred septum. RESULTS. Eighty-six patients were treated from August 2010 till March 2016. Baseline EF was 30±8% and ESVi 72±28 ml/m². Four patients (4.7%) died in-hospital and 1 (1.2%) had a stroke. Two-year survival was 89.2%. In 57 patients who completed 2-year follow up, EF improved (+13%) and LVESVI reduced (-27%). NYHA class reduced (2.6±0.5 to 1.8±0.7, P<0,001), 6-minutes walking test increased (353±108 to 432±102 minutes, P<0.001) and Minnesota Living with Heart Failure score reduced (41±21 to 24±19, P<0.001). Serial echocardiograms and functional evaluations (@6,12,24 months) demonstrated sustained improvements. CONCLUSIONS. Excellent survival and sustained improvement of echocardiographic and functional parameters are obtained using the Less Invasive Ventricular Enhancement technique. In patients with no significant MR and/or myocardial ischemia, ventricular reduction and reshaping, when performed off-pump using the Revivent myocardial anchors, demonstrates long term decrease in heart failure symptoms.

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