We are continuing development of this novel catheter technique, which establishes circumferential tension around the mitral valve annulus by exploiting both natural (coronary venous) and un-natural (intramyocardial septal) trajectories. We have established proof-of-principal in a porcine model of ischemic cardiomyopathy that cerclage annuloplasty reduces secondary (""""""""functional"""""""") mitral valve regurgitation. We have developed new catheter designs to simplify the procedure. We are attempting to reduce the demands on image guidance for the procedure. We have obtained institutional approval for a public SBIR solicitation to partner with small private companies to develop and refine catheter tools for cerclage, to be tested in patients in the future at the NIH Clinical Center. We have conceived a wholly new approach to treat tricuspid valve regurgitation.

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National Heart, Lung, and Blood Institute
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Khan, Jaffar M; Rogers, Toby; Schenke, William H et al. (2016) Intentional Laceration of the Anterior Mitral Valve Leaflet to Prevent Left Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Replacement: Pre-Clinical Findings. JACC Cardiovasc Interv 9:1835-43
Ratnayaka, Kanishka; Rogers, Toby; Schenke, William H et al. (2016) Magnetic Resonance Imaging-Guided Transcatheter Cavopulmonary Shunt. JACC Cardiovasc Interv 9:959-70
Wang, Dee Dee; Eng, Marvin; Greenbaum, Adam et al. (2016) Predicting LVOT Obstruction After TMVR. JACC Cardiovasc Imaging 9:1349-1352
Rogers, Toby; Mahapatra, Srijoy; Kim, Steven et al. (2016) Transcatheter Myocardial Needle Chemoablation During Real-Time Magnetic Resonance Imaging: A New Approach to Ablation Therapy for Rhythm Disorders. Circ Arrhythm Electrophysiol 9:e003926
Uflacker, Andre; Lim, Scott; Ragosta, Michael et al. (2015) Transcaval Aortic Access for Percutaneous Thoracic Aortic Aneurysm Repair: Initial Human Experience. J Vasc Interv Radiol 26:1437-41
Rogers, Toby; Ratnayaka, Kanishka; Schenke, William H et al. (2015) Intentional right atrial exit for microcatheter infusion of pericardial carbon dioxide or iodinated contrast to facilitate sub-xiphoid access. Catheter Cardiovasc Interv 86:E111-8
Lederman, Robert J; O'Neill, William W; Greenbaum, Adam B (2015) Transcaval access for TAVR across a polyester aortic graft. Catheter Cardiovasc Interv 85:1270-3
Rogers, Toby; Ratnayaka, Kanishka; Schenke, William H et al. (2015) Fully percutaneous transthoracic left atrial entry and closure as a potential access route for transcatheter mitral valve interventions. Circ Cardiovasc Interv 8:e002538
Rogers, Toby; Ratnayaka, Kanishka; Sonmez, Merdim et al. (2015) Transatrial intrapericardial tricuspid annuloplasty. JACC Cardiovasc Interv 8:483-91
Greenbaum, Adam B; Rogers, Toby; Paone, Gaetano et al. (2015) Intentional Right Atrial Exit and Carbon Dioxide Insufflation to Facilitate Subxiphoid Needle Entry Into the Empty Pericardial Space: First Human Experience. JACC Clin Electrophysiol 1:434-441

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