News | Guidewires | May 30, 2017

Canadian Cardiologist Publishes World-First Mitral Regurgitation Procedure

MitraClip device inserted through jugular vein of 86-year-old patient with SupraCross RF Solution from Baylis Medical Co. Inc.

May 30, 2017 — A Canadian cardiologist has published a report in the journal Eurointervention describing how he used a Canadian-invented device for the first time in the world to successfully insert a MitraClip through a patient's jugular vein rather than the femoral vein.

When Neil Fam, M.D., examined his 86-year-old patient with severe mitral regurgitation — a condition in which the blood flows backward into the heart after it contracts — his options for treating her were limited.

Because of her age and overall health, Ortensia Aceti of Sault Ste. Marie, Ont., was not a good candidate for surgery to repair her mitral valve. She had been in and out of hospital with heart failure and medication was no longer controlling her symptoms.

Instead, he decided on a catheter-based treatment to guide a MitraClip device to the heart and clamp the leaky valve. The catheter would usually be inserted through the femoral vein in the leg, but her vein was blocked.

"We were locked out, blocked from accessing her heart," said Fam, an interventional cardiologist and director of the Cardiac Intensive Care Unit of St. Michael's Hospital in Toronto.

Fam recalled a conversation he had about a year previously with Baylis Medical Co. Inc., a Canadian supplier of high-tech cardiology equipment, about one of their devices that was designed to achieve access to the heart from alternative approaches.

For the first time in the world, Fam successfully used the company's SupraCross RF Solution to guide a MitraClip device through the jugular vein — a more direct route to the heart — and successfully repair Aceti's leaking mitral valve.

Fam said this was possible, despite the awkward angle of the jugular vein in relation to the heart, because the tip of the sheath is steerable and the wire is equipped to deliver radiofrequency energy to puncture the septum of the heart. This allows the physician to position the system appropriately from this challenging angle and puncture the septum of the heart in a precise and controlled manner without using excessive force.

Fam said Aceti had no complications and her condition improved, allowing her to be discharged to her home. At a follow-up appointment, she was doing well with no further heart failure.

Fam said that while this procedure would be appropriate for only selected patients, they are high-risk patients for which there may be no other treatment options.

"Given the success of this procedure, the door is open for future studies of the jugular approach for treating the mitral valve," he said.

For more information: www.pcronline.com/eurointervention

Related Content

TCT cancels in-person meeting and goes virtual due to COVID-19
News | Cath Lab | May 27, 2020
May 27, 2020 — To ensure the health and safety of all attendees due to the ongoing COVID-19 (SARS-CoV-2) pandemic, th
Patients undergoing cardiac catheterization are traditionally instructed to follow nothing by mouth, or nil per os (NPO), as there are no current standardized fasting protocols, but the CHOWNOW study found patients do not need to fast and will have similar outcomes. #SCAI2020
Feature | Cath Lab | May 18, 2020
May 18, 2020 – Patients undergoing cardiac catheterization are traditionally instructed to follow nothing by mouth, o
htisham Mahmud, M.D., FSCAI, president of the Society for Cardiovascular Angiography and Interventions (SCAI) and chief, Division of Cardiovascular Medicine at UC San Diego Medical Center,
Podcast | Cath Lab | May 13, 2020
This podcast is an interview with Ehtisham Mahmud, M.D., FSCAI, president of the Society for Cardiovascular Angiograp
Nuance Communications Inc. introduced Nuance Cardiovascular CAPD, a new computer-assisted physician documentation (CAPD) solution designed to help cardiologists improve the quality of complex documentation and the accuracy of reimbursement for cardiac catheterization procedures. The Nuance Cardiovascular CAPD solution is available through a partnership with ZHealth for this solution, which is based on patented algorithms built with ZHealth’s interventional documentation and coding expertise.
News | Cath Lab | January 31, 2020
January 29, 2020 – Nuance Communications Inc.
Videos | Cath Lab | January 09, 2020
Haval Chweich, M.D., medical director of the cardiac critical care unit (CCU) at Tufts Medical Center, and assistant...
People watch the live presentation of the five-year EXCEL Trial data by Gregg Stone, M.D., in the Abbott booth at TCT 2019. Abbott makes the Xience stent used in the trial, which compared equally with long-term CABG surgical outcomes.  In early December 2019, leaders of the European Association for Cardiothoracic Surgery (EACTS) withdrew their support for European practice guidelines that endorse the use of coronary stents in many patients with left main coronary artery disease.

People watch the live presentation of the five-year EXCEL Trial data by Gregg Stone, M.D., in the Abbott booth at TCT 2019. Abbott makes the Xience stent used in the trial, which compared equally with long-term CABG surgical outcomes.

News | Cath Lab | January 02, 2020 | Dave Fornell, Editor
January 2, 2020 — In early December 2019, leaders of the European As...