We are continuing development of transcatheter mitral cerclage annuloplasty, a novel 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. An SBIR contract was awarded to a small business to develop clinical prototypes, 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 called transauricular intrapericardial tricuspid annuloplasty (TRAIPTA). We have developed a new technique to introduce large implants into the aorta for transcatetheter aortic valve replacement and related procedures, by crossing from the inferior vena cava into the abdominal aorta. This challenges the long-held paradigm that the aortic wall must remain inviolate during non-surgical procedures.

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National Heart, Lung, and Blood Institute
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Greenbaum, Adam B; O'Neill, William W; Paone, Gaetano et al. (2014) Caval-aortic access to allow transcatheter aortic valve replacement in otherwise ineligible patients: initial human experience. J Am Coll Cardiol 63:2795-804
Lederman, Robert J; Chen, Marcus Y; Rogers, Toby et al. (2014) Planning transcaval access using CT for large transcatheter implants. JACC Cardiovasc Imaging 7:1167-71
Sinha, Pranava; Deutsch, Nina; Ratnayaka, Kanishka et al. (2014) Effect of mechanical assistance of the systemic ventricle in single ventricle circulation with cavopulmonary connection. J Thorac Cardiovasc Surg 147:1271-5
Faranesh, Anthony Z; Kellman, Peter; Ratnayaka, Kanishka et al. (2013) Integration of cardiac and respiratory motion into MRI roadmaps fused with x-ray. Med Phys 40:032302
Halabi, Majdi; Faranesh, Anthony Z; Schenke, William H et al. (2013) Real-time cardiovascular magnetic resonance subxiphoid pericardial access and pericardiocentesis using off-the-shelf devices in swine. J Cardiovasc Magn Reson 15:61
Halabi, Majdi; Ratnayaka, Kanishka; Faranesh, Anthony Z et al. (2013) Transthoracic delivery of large devices into the left ventricle through the right ventricle and interventricular septum: preclinical feasibility. J Cardiovasc Magn Reson 15:10