Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    


Breakthroughs Offer New Hope for Heart Failure Patients


 

Percutaneous treatment option for mitral regurgitation shows promise

Approximately 5 million Americans suffer from heart failure. Roughly, half of these have heart failure with reduced ejection fraction (EF), of whom at least half have some degree of functional mitral regurgitation (FMR).

Functional mitral regurgitation is commonly found in patients with underlying myocardial dysfunction and results from decreased left ventricular (LV) closing forces and from distortion of the LV geometry tethering the structurally normal mitral leaflets. Severe FMR is associated with increased morbidity and mortality independent of both LV ejection fraction (LVEF) and clinical markers of heart failure.

The prognosis is poor for patients with heart failure who have mitral regurgitation due to left ventricular dysfunction. Conventional treatment options have included surgery to repair or replace the mitral valve or medication therapies to mitigate symptoms. Many of these patients are too high risk for surgical interventions. Medication therapies are helpful at treating heart failure symptoms but do not address the underlying structural defect. Despite advances in medical therapy, mortality rates remain high for patients with FMR.

Significant and rapidly evolving advancements in the treatment of FMR underscore the importance of ensuring patients have access to a multidisciplinary cardiology team that is not only skilled in treating the entire scope of heart disease, but also is helping to chart the course for innovative therapies, minimally invasive techniques and devices that lengthen mortality and improve quality of life.

In the last five to ten years, research has led to less invasive options for patients who are too high a risk for surgical interventions to treat heart disease. A percutaneous approach using the MitraClip in the treatment of degenerative mitral regurgitation has proven effective for high-risk patients or those at increased risk of death or hospitalization for heart failure.

A study published this fall in the New England Journal of Medicine indicates a transcatheter mitral-valve repair may also improve clinical outcomes in patients with FMR.

The COAPT study enrolled 614 patients at 78 sites in the U.S. and Canada. The study concluded, "Among patients with heart failure and moderate-to-severe or severe secondary mitral regurgitation who remained symptomatic despite the use of maximal doses of guideline-directed medical therapy, transcatheter mitral-valve repair resulted in a lower rate of hospitalization for heart failure and lower all-cause mortality within 24 months of follow-up than medical therapy alone." (NEJM)

The trial was significant in that it was the first time any intervention for FMR has demonstrated a mortality benefit. The interventional procedure was performed in a catheterization lab under general anesthesia and patients were typically hospitalized overnight. In carefully selected patients treated with the MitraClip, incidence of hospitalization decreased from 67.9 percent to 35 percent and mortality decreased from 46.1 percent to 29.1 percent.

On the heels of this breakthrough news, TriStar Centennial Medical Center has been named the only site in the region to offer The CARILLON Trial and is currently evaluating the Carillon Mitral Contour System for patients with FMR. This percutaneous mitral annuloplasty technique allows interventional cardiologists to perform a procedure similar to what surgeons have been doing successfully for years, but less invasively to reduce risks for patients.

The trial device is placed in a vessel next to the base of the mitral valve and helps to align the leaflets to reduce the amount of regurgitation a patient may experience. In comparison to other trials of other therapies, this trial includes patients with a moderate leak or lesser degree of regurgitation to help determine if earlier intervention is helpful. While the impact these therapies may have to 'fix' the weakened heart muscle is still being determined, it is possible that reducing the amount of mitral regurgitation will prevent further negative remodeling by interrupting the cycle and have a positive impact on a patient's longevity.

TriStar Centennial Medical Center is currently enrolling patients in The CARILLON Trial who have an ejection fraction ≤ 50 percent and 2+ moderate or more mitral regurgitation. Centennial Heart expects to be a top enroller in the trial, which will include 450 patients internationally.

It is critical for patients suffering from complex heart disease to seek treatment where they can be afforded that full spectrum of treatment options. TriStar Centennial Medical Center offers patients a collaborative approach that includes heart failure specialists, structural heart interventionalists and cardiac surgeons who specialize in advanced cutting-edge treatment options to treat the most complex cardiac disorders.

For more information about the Carillon Mitral Contour System trial and to refer a patient for enrollment consideration, please call (615) 342-4636.


Sponsored content courtesy TriStar Centennial Medical Center. Andrew Goodman, MD, is an Interventional Cardiologist with Centennial Heart. For more information go online to tristarcentennial.com.

 
Share:

Related Articles:


Recent Articles

Alexander: Bipartisan Legislation Will Lower What Americans Pay Out of Their Own Pockets for Health Care

The Lower Health Care Costs Act of 2019 contains nearly three dozen proposals from at least 16 Republican, 14 Democrat senators

Read More

If You Build It, They Will Come

Middle Tennessee's healthcare options continue to expand through new construction and facility renovations and additions.

Read More

Lease, Build, Buy, Sell: Finding the Best Fit for Each Medical Practice

When it comes to medical real estate, there is no one 'right' answer for every practice. Instead, experts say it's important to understand all the options before making a decision that impacts individual physicians, the practice ... and ultimately, patients.

Read More

Dr. Jerry Tannenbaum: Redefining, Redesigning Nephrology

Innovative building models and telemedicine mean better care for patients nationwide.

Read More

Wayfinding in Healthcare

With expansions, renovations and additions to healthcare facilities over time, the ability to easily navigate a campus is often lost along the way. Taking time to consider wayfinding can vastly improve the way patients, visitors and staff engage with the environment.

Read More

Building Walls

Steve Ward & Associates prefab headwalls mean more savings, options for healthcare clients.

Read More

LipiFlow®: Advanced Procedure to Treat Meibomian Gland Dysfunction & Chronic Dry Eye

In-office procedure can promote eyelid health and provide relief from dry eye.

Read More

SCALE 2019 Showcases Latest in Aesthetics Medicine

Now in its 14th year, the Music City SCALE Conference broke previous attendance records, with plans for additional growth in 2020.

Read More

Rethinking the Approach to Acne

New options and research have changed the traditional approach to treating acne.

Read More

Financing the Deal

Healthcare investment experts gathered for the Nashville Health Care Council's annual Financing the Deal panel focused on private equity trends and strategies.

Read More

Email Print
 
 

 

 


Tags:
Andrew Goodman, CARILLON Trial, FMR, Functional Mitral Regurgitation, Mitral Valve, TriStar Centennial Medical Center
Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: