Abstract
Patients with functional, or secondary, mitral regurgitation (FMR, SMR) often face significant symptoms that lead to functional decline as well as hospitalization and even death. Traditional mitral annuloplasty is an important treatment option for patients with FMR, but surgical risk and durability are important limitations. Percutaneous strategies are therefore a welcome alternative. The Carillon device utilizes the relationship of the coronary sinus and the mitral annulus to effect an “indirect” annuloplasty. Early series' and recent randomized trials suggest echocardiographic and clinical benefit with a relatively straight-forward implantation technique and low rate of significant complications.
Highlights
Secondary, mitral regurgitation (FMR, SMR) often face significant symptoms that lead to functional decline as well as hospitalization and even death [1]
While guideline-directed medical therapy (GDMT) for heart failure is recommended for all, and often provides some relief, many patients remain symptomatic
While pathologic left ventricular (LV) dilation is an important part of mitral regurgitation (MR), the contemporary understanding implicates either idiopathic annular dilation without LV dilation or atrial fibrillation/flutter alone as the primary etiology in more than one-third of SMR patients [6]
Summary
Secondary, mitral regurgitation (FMR, SMR) often face significant symptoms that lead to functional decline as well as hospitalization and even death. Traditional mitral annuloplasty is an important treatment option for patients with FMR, but surgical risk and durability are important limitations. The Carillon device utilizes the relationship of the coronary sinus and the mitral annulus to effect an “indirect” annuloplasty. Series’ and recent randomized trials suggest echocardiographic and clinical benefit with a relatively straight-forward implantation technique and low rate of significant complications. St. Michael’s Hospital, Canada David Chistian Reineke, Clinic for Cardiovascular Surgery, Inselspital, Switzerland. Specialty section: This article was submitted to Structural Interventional Cardiology, a section of the journal Frontiers in Cardiovascular Medicine.
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