The Clinical Problem
Congestive Heart Failure (CHF) is a complex disease that leads to debilitation and mortality. After an initial insult usually involving ischemic, hypertensive, or idiopathic factors, the heart suffers muscle damage and shifts the workload to the remaining healthy muscle. To compensate, the heart geometrically remodels causing increased load and stress, which causes further damage, thus perpetuating a vicious cycle.
Mitral regurgitation associated with CHF is called functional mitral regurgitation (FMR), and results from dilation of the mitral annulus primarily along the minor septal-lateral axis. As the annulus dilates, the valve leaflets can no longer coapt and blood leaks or regurgitates back into the atrium during systole. The heart compensates for the regurgitation by working harder in an effort to maintain cardiac output. If left untreated, this leads to further stress on the heart, muscle damage and accelerated congestive heart failure.
"The ARTO System provides an opportunity not previously available to patients of congestive heart failure. The ARTO System is administered in an extremely calm and low-risk procedure to improve heart function
and enhance quality of life."
– Andrejs Erglis, MD, Chief of Latvian Centre of Cardiology
at Paul Stradins Clinical University Hospital
The ARTO System is a unique endovascular therapy for mitral valve regurgitation associated with congestive heart failure. The system treats heart failure by reducing the backward leakage of blood through the mitral valve thereby increasing the forward flow of blood to the rest of the body. ARTO directly reshapes the mitral annulus and improves leaflet coaptation by shortening the minor axis of the mitral valve through inward displacement of the septal and lateral walls. This reestablishes normal anatomic relationships and decreases regurgitation.
Description of the ARTO Procedure: Using fluoroscopy, delivery and deployment of the System are accomplished through venous access to the right atrium where two common procedures are performed: (1) the coronary sinus is cannulated and a T-bar implant is deployed in the lateral wall via the great cardiac vein; and (2) a septal implant is deployed through a trans-septal puncture. A bridge between these two anchors provides the means for inward displacement and subsequent reduction of the valve’s minor axis. The bridge length is then adjusted to achieve optimal therapeutic reduction of the regurgitation.
ARTO Key Elements
- Immediate and Direct A-P Diameter Shortening to Treat FMR
- No compression of LCX or other coronary arteries
- Venous Based Delivery Under Fluoroscopic Imaging
- Customizable to Anatomy
- Acutely Reversible or Removable
- 12 Fr Venous Delivery System
- No residual ASD, no trauma to native MV leaflets or chords
- Does not preclude future therapy