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. While we refine devices, we are working to issue new contracts to small businesses to to fund collaborative translation of this novel technique into patients. We have conceived a wholly new approach to treat tricuspid valve regurgitation called transauricular intrapericardial tricuspid annuloplasty (TRAIPTA). We have demonstrated the success of TRAIPTA to reduce functional tricuspid regurgitation in a new animal model. We recently entered into a Collaborative Research and Development Agreement with a large catheter company to develop this technique for testing in patients. We have developed a new technique to introduce large implants into the aorta for transcatheter 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. The technique has proven lifesaving in over three dozen patients. We are sponsoring a multicenter evaluation of the technique while we develop purpose-built devices to close the access port. This technology has applications in the treatment of numerous congenital heart diseases and in allowing novel non-surgical access to the heart. We are developing an innovative approach to access the heart through the chest wall without surgery. We are working collaboratively with a small business to develop a partial mitral valve replacement without surgery, using a novel outside invention to replace the posterior mitral valve leaflet to treat mitral valve regurgitation whether functional or degenerative.

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Support Year
5
Fiscal Year
2014
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Name
U.S. National Heart Lung and Blood Inst
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Khan, Jaffar M; Lederman, Robert J; Sanon, Saurabh et al. (2018) Transcatheter Mitral Valve Replacement After Transcatheter Electrosurgical Laceration of Alfieri STItCh (ELASTIC): First-in-Human Report. JACC Cardiovasc Interv 11:808-811
Rogers, Toby; Lederman, Robert J (2018) Percutaneous transaxillary access for TAVR: Another opportunity to stay out of the chest. Catheter Cardiovasc Interv 91:157-158
Kasel, A Markus; Rumpf, Moritz; Frangieh, Antonio H et al. (2018) International LAMPOON: first European experience with laceration of the anterior mitral valve leaflet prior to transseptal transcatheter mitral valve implantation. EuroIntervention 14:746-749
Khan, Jaffar M; Lederman, Robert J (2018) Transcatheter electrosurgery in bipolar or monopolar modes. Catheter Cardiovasc Interv 91:1052-1053
Greenbaum, Adam B; Condado, Jose F; Eng, Marvin et al. (2018) Long or redundant leaflet complicating transcatheter mitral valve replacement: Case vignettes that advocate for removal or reduction of the anterior mitral leaflet. Catheter Cardiovasc Interv 92:627-632
Khan, Jaffar M; Rogers, Toby; Babaliaros, Vasilis C et al. (2018) Predicting Left Ventricular Outflow Tract Obstruction Despite Anterior Mitral Leaflet Resection: The ""Skirt NeoLVOT"". JACC Cardiovasc Imaging 11:1356-1359
Khan, Jaffar M; Dvir, Danny; Greenbaum, Adam B et al. (2018) Transcatheter Laceration of Aortic Leaflets to Prevent Coronary Obstruction During Transcatheter Aortic Valve Replacement: Concept to First-in-Human. JACC Cardiovasc Interv 11:677-689
Khan, Jaffar M; Rogers, Toby; Eng, Marvin H et al. (2018) Guidewire electrosurgery-assisted trans-septal puncture. Catheter Cardiovasc Interv 91:1164-1170
Babaliaros, Vasilis; Greenbaum, Adam B; Kamioka, Norihiko et al. (2018) Bedside Modification of Delivery System for Transcatheter Transseptal Mitral Replacement With POULEZ System and SAPIEN-3 Valve. JACC Cardiovasc Interv 11:1207-1209
Khan, Jaffar M; Rogers, Toby; Schenke, William H et al. (2018) Transcatheter pledget-assisted suture tricuspid annuloplasty (PASTA) to create a double-orifice valve. Catheter Cardiovasc Interv 92:E175-E184

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