Percutaneous implantation of an intraventricular device for the treatment of heart failure: experimental results and proof of concept.

ABSTRACT

BACKGROUND: A percutaneous system to implant a ventricular partitioning device (VPD) has been developed to partition the left ventricular (LV) cavity for treating regional wall motion abnormalities associated with post-left anterior descending (LAD) infarction, dilated left ventricle, and systolic dysfunction. The hemodynamic effects of this novel approach were evaluated in an ovine model with an anteroapical infarction created by a coil placed in the LAD. METHODS AND RESULTS: LV anteroapical infarction (MI) was induced in 10 animals. The VPD device was implanted at 6 weeks after MI in 5 animals. The hemodynamic status of each animal was evaluated at 30 weeks post-MI in treated ("VPD+MI" group, n=5) and nontreated ("MI" group, n=5). The comparison of end-point hemodynamic variables shows a significantly smaller end-systolic LV volume in the animals receiving the implant (70.1+/-9.0 mL in "VPD+MI" group vs. 102.9+/-10.3 mL in "MI" group, P < .02), improved ejection fraction (46.9+/-5.2% in "VPD+MI" group vs. 34.7+/-6.8% in "MI" group, P < .04) and preserved cardiac output (5.2+/-0.7 L/min in "VPD+MI" group vs. 5.0+/-1.8 L/min in "MI" group, P=NS), suggesting more efficient mechanical performance of the LV with the implanted VPD. CONCLUSIONS: A significant reduction in LV volumes and corresponding improvement in LV function occurred after device implantation indicating a potential beneficial effect of this new device in treatment of post MI LV dilation.