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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