Safety and efficacy of less-invasive ventricular enhancement procedure with the transcatheter Revivent TCTM system in patients with left ventricular aneurysm: a systematic review.

Abstract

Left ventricular (LV) aneurysm following acute myocardial infarction (MI) represents a less common complication, but with worse clinical outcomes. Ventricular surgical reconstruction is not always the intervention of choice due to high surgical risk. There were proposed less invasive LV aneurysm exclusion techniques such as the less invasive ventricular enhancement (LIVE) procedure. Our paper represents the first systematic approach to investigate the efficacy and safety of LIVE procedure using Revivent TCTM anchor system for LV aneurysm exclusion. Studies were considered if they reported original data regarding LIVE procedure's efficacy and/or safety using the Revivent TCTM system in patients with LV aneurysms. Five studies met the inclusion criteria. The procedure is associated with a reduction in LV volumes and an improvement in LV ejection fraction (LVEF). The means of preoperative LVEF varied between 22.8% and 35.6%, while postoperative LVEF means ranged between 34% and 45.9% (P < 0.005) across studies. All included papers reported a significant difference between preoperative and postoperative LV end-systolic volume index (P ≤ 0.001) and LV end-diastolic volume index (P ≤ 0.001). Three out of four studies achieved statistical significance (P ≤ 0.001) when comparing preoperative (means range: 2.6-3.4) and postoperative (means range: 1.4-1.9) New York Heart Association (NYHA) class. One study reported a survival rate of 90.6 (95% CI, 84.6-97.0) at 12 months following the procedure. LIVE appears to be a promising and appropriate treatment strategy for a complex condition, which could extend the indication of LV aneurysm exclusion in the future.