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.