Mitral valve repair without cardiopulmonary bypass or atriotomy using the Coapsys device: Device design and implantation procedure in canine functional mitral regurgitation model

Background: Myocor developed a unique system, the Coapsys annuloplasty system, to treat functional mitral regurgitation (MR) without cardiopulmonary bypass (CPB). This study was conducted to test the feasibility of the Coapsys implantation procedure in a canine functional MR model. Methods: Functional MR with heart failure was induced in 9 dogs by rapid ventricular pacing (230 beats/min for 30 ± 4 days). The Coapsys device, which consists of anterior and posterior epicardial pads connected by a subvalvular chord, was then surgically implanted. Under epicardial echocardiographic guidance, we placed the Coapsys device across the left ventricular chamber using the delivery instrument and needle assembly. We sized the Coapsys device by drawing the posterior leaflet and annulus toward the anterior leaflet with the sizing instrument. Final device size was selected when MR was minimized or eliminated as assessed by 2-dimensional color Doppler echocardiography. Results: In all cases, we successfully implanted the Coapsys device without CPB or atriotomy. MR was reduced an average of 2 grades. No adverse events, such as hemodynamic compromise or structural valve damage, were noted. Conclusion: Coapsys device implantation was feasible and safe on a beating canine heart. All accessory tools used for device implantation were found useful.