Mitral Valve Repair
Mitral Valve Regurgitation
Mitral regurgitation (MR) is a condition in which the mitral valve doesn't close tightly, allowing blood to flow backward in the heart. As many as one in five people over the age of 55 have some degree of mitral regurgitation. NeoChord's first medical technology is being developed to treat some forms of this condition.
The mitral valve controls blood flow between the left atrium and left ventricle. It consists of two flaps of tissue called leaflets. The mitral valve annulus forms a ring around the valve leaflets, connecting them to the heart muscle. The papillary muscles are attached to the base of the left ventricle. Anchoring the mitral valve leaflets to the papillary muscles are tendon-like chords called chordae tendineae. These chords prevent the leaflets from prolapsing into the left atrium. During normal cardiac function, the left atrium contracts and forces blood through the mitral valve and into the left ventricle. When the left ventricle contracts, the mitral valve leaflets close snugly and prevent the backflow of blood from the left ventricle into the left atrium.
When working properly, the mitral valve opens and closes fully. In mitral regurgitation, the mitral leaflets don't close tightly causing some blood to flow backward into the left atrium upon left ventricular contraction. Some of the back flowing blood may enter into the pulmonary veins, creating congestion in the lungs. This backflow of blood through the heart valve is called regurgitation. One primary cause of MR is broken or elongated chords.
Because some of the blood regurgitates into the left atrium, less blood is pumped into the aorta and ultimately, throughout the body. Over time, the heart compensates for this reduced blood flow by increasing the size of the left ventricle in an attempt to pump adequate blood to meet the body's needs. Left unchecked, MR may lead to additional complications, including atrial fibrillation and congestive heart failure.
Current Treatment Options
Treatment for MR depends on the severity of the disease and the symptoms experienced by the patient. Patients with mild to moderate MR and no symptoms are typically left untreated. Those with severe MR, even if asymptomatic, might require surgical repair or replacement of the valve. The standard of care for mitral valve surgery is open heart surgery which involves a sternotomy (sawing open the sternum) and cardiopulmonary bypass (stopping the heart and having breathing and blood circulation performed by a machine).
In valve replacement surgery, the damaged mitral valve is replaced with a prosthetic valve. Valve replacement is typically done when valve repair is not possible.
When mitral valve repair is needed to address ruptured or elongated chordae tendineae, typically either artificial chords are implanted or the prolapsing segment of the leaflet is removed via leaflet resection. Most repair techniques today also include annuloplasty which is a buttressing of the valve annulus typically accomplished via implantation of an artificial ring.
Clinical trials will be intended to show that NeoChord's proprietary delivery system will allow implantation of artificial chords without the need for the sternotomy and cardiopulmonary bypass required in open heart surgery.
Caution: The NeoChord device is an investigational device and is limited by U.S. Federal law to investigational use. FOR CLINICAL TRIAL USE ONLY.