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Archive for the ‘Implantation’ Category

Tricuspid Flow Optimizer, FDA Approved, 6 months follow up of the First-in-Man Implantation in Rome, Italy

Reporter: Aviva Lev-Ari, PhD, RN

UPDATED on 10/29/2024

Innoventric Secures $28.5M and Unveils Groundbreaking Tricuspid Regurgitation Treatment to Help Patients, Many of Whom Were Previously Untreatable 
 
Reduces Treatment Risk By Eliminating the Need for Surgical Valve Replacement and General Anesthesia – Which Ensures Shorter Operations 
 
New York, NY — Innoventric, a leader in transcatheter tricuspid regurgitation (TR) treatment, today announced a $28.5 million Series B funding round to advance its revolutionary cross-caval technology, bringing the total funds raised since inception to $41 million. Innoventric has already successfully completed a first-in-human clinical trial in Europe, and performed many additional implantations — treating over 40 participants so far. Recently, the company received FDA clearance for an Early Feasibility Study (EFS) in the US, and patient enrollment is actively ongoing with the first US patients already treated. The funds raised will be used to advance clinical trials and expand regulatory approvals in the US and Europe.
 
Innoventric’s device addresses tricuspid regurgitation, a severe condition that impairs the cardiac blood flow, by replacing the native valve’s function through a heterotopic, cross-caval approach. With Innoventric, a prosthetic valve is anchored to the vena cava instead of the beating heart, so a complete seal is achieved without the risk of leakage or detachment. This method simplifies the implantation process and overcomes the anatomical complexities associated with traditional treatments. Positioned at the forefront of the $10 billion annual transcatheter heart valve replacement market, Innoventric’s technology is poised to transform tricuspid valve treatment.
 
The Innoventric device offers significant advantages:
Broad Patient Applicability: Designed for various anatomies, it extends treatment options to patients who are typically ineligible for tricuspid procedures.
Innovative Anchoring Technique: It anchors securely to the tubular superior vena cava (SVC) and inferior vena cava (IVC), instead of the moving heart, minimizing risks such as leakage or detachment.
Streamlined Procedure: The device can be implanted rapidly without the use of echocardiography or general anesthesia, significantly improving success rates and reducing patient recovery time.
 
The round was led by RA Capital Management, with new investment from the European Investment Committee (EIC). Returning investors BRM Group, JG Private Equity, and Mivtach Shamir Holdings also participated, reinforcing their confidence in Innoventric’s path-breaking technology.
 
Amir Danino, CEO of Innoventric, stated: “Our mission is to revolutionize tricuspid regurgitation care with minimally invasive therapies that significantly improve patient outcomes. The strong backing from our investors, coupled with the progress we’ve achieved, underscores the need and huge potential of our approach to treat TR.”
 
Anurag Kondapalli, Principal at RA Capital, said: “We are excited to support Innoventric as it looks to transform the approach to TR treatment. The strong outcomes from their European first-in-human trial demonstrate the immense potential of their anatomy-agnostic device to treat a broader range of patients who have lacked viable options. We have been very impressed with Innoventric’s technology and leadership, and believe their solution has the potential to reshape the future of TR care.”
 
To learn more about Innoventric and its world leading approach, visit https://innoventric.com/.  
 
About Innoventric
Since its foundation in 2017, Innoventric has been committed to addressing the complexities of tricuspid regurgitation with its innovative transcatheter TR solutions. As leaders in cross-caval technologies, Innoventric is dedicated to the ongoing development of advanced devices to extend the reach of TR treatment. Innoventric’s approach is rigorously data-driven, with its roots grounded deep in clinical research, and its treatments are designed to benefit a broad spectrum of patients, with the aim of making high-quality care more accessible and improving health outcomes. Visit https://innoventric.com/ to learn more.

SOURCE

From: Brook Terran <brook@evergreenandoak.com>
Reply-To: Brook Terran <brook@evergreenandoak.com>
Date: Tuesday, October 29, 2024 at 11:39 AM
To: Aviva Lev-Ari <avivalev-ari@alum.berkeley.edu>
Subject: $28.5M Funding Round Solves Cardiac Issue

 

 

Tricuspid Flow Optimizer graphic courtesy of Triflo Cardiovascular.

TR – Tricuspid Regorgitation

the Tricuspid Flow Optimizer, was developed by Triflo Cardiovascular, a U.S.-based biomedical company founded in 2017 by a team of structural heart specialists.

After using CT and transesophageal echocardiography (TEE) scans to confirm the procedure was feasible, the care team implanted the device. It includes three anchors that are positioned at the tricuspid valve’s commissures. A 37 French steerable catheter was positioned in the patient’s right atrium for the implant, and the device’s positioning was “optimized” before being released. A second TEE scan confirmed the device had been successfully implanted. The patient was discharged after four days of recovery, and a permanent pacemaker was required after three weeks due to slow-rate AFib.

Six months later, the authors reported, reserve remodeling of the right ventricle and a clear improvement in TR were evident, moderate tricuspid regurgitation.

“The minimal interaction with the right cardiac chamber resulted in an easy implantation of the pacemaker; the polymer leaflets and the minimal footprint demonstrated an optimal adaptation to the native anatomy and stability through six months’ follow-up.”

SOURCES

Original Study:

1. Gian Paolo Ussia, Antonio Mangieri, Valeria Cammalleri, et al. 6 Months’ Follow-Up of the First-in-Man Implantation of a Novel Tricuspid Flow Optimizer. J Am Coll Cardiol Intv. Apr 17, 2024.

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Cardiac Surgery Recommendations Switch to Patient Blood Management

— Four societies outline pre- to post-op strategies to improve outcomes

by Crystal Phend, Contributing Editor, MedPage Today June 30, 2021

Reporter: Aviva Lev-Ari, PhD, RN

STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

Published:June 30, 2021 DOI:https://doi.org/10.1016/j.athoracsur.2021.03.033

Switching from “blood conservation” to the broader “patient blood management” (PBM) approach is probably the biggest change, Tibi told MedPage Today.

“Basically we’re considering blood as another vital organ,” he said. “Why that is important is because now we look at a patient’s blood system as an organ that needs to be assessed and treated for the sake of that organ and not simply to decide when or when not to transfuse.”

Recommendations span the entire spectrum from preoperative assessment of bleeding risk and anemia to intraoperative perfusion and blood salvage practices to postoperative treatment with human albumin for volume replacement.

“Most hospitals around the U.S. are acutely aware of patient blood management and, to some degree or another, are implementing many of the things we are talking about,” noted Tibi, who is immediate past president of SABM. Nationwide, the amount of blood transfused in cardiac surgery has dropped 45% in the past 10 to 15 years but still ranges widely from center to center.

SOURCE

https://www.annalsthoracicsurgery.org/article/S0003-4975(21)00556-7/fulltext

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Left ventricular outflow tract (LVOT) obstruction (LVOTO): The Role of CT in TAVR and in TMVR

Reporter: Aviva Lev-Ari, PhD, RN

 

Left ventricular outflow tract obstruction (LVOTO) is a recognised feature of this condition which arises when blood leaving the outflow tract is impeded by systolic anterior motion of the mitral valve. LVOT obstruction was defined as a resting LVOT gradient of ≥30 mm Hg, with severe obstruction defined as ≥50 mm Hg (15).

Left ventricular outflow tract (LVOT) obstruction can occur at the valvular, subvalvular, or supravalvular level. In general, there is an obstruction to forward flow which increases afterload, and if untreated, can result in hypertrophy, dilatation, and eventual failure of the left ventricle. In the United States, most cases of LVOT obstruction are congenital in individuals younger than 50 years of age.

Jonathon Leipsic, M.D., FSCCT, professor of radiology and cardiology at the University of British Columbia, Vancouver, Canada, and an expert in transcatheter valve imaging. He spoke about his experiences with TAVR and TMVR trials and devices planning at the the Society of Cardiovascular Computed Tomography (SCCT) 2018 meeting.

Watch the VIDEO “What to Look for in CT Structural Heart Planning Software.”

Issues of Concern

Common Causes of Left Ventricular Outflow Tract Obstruction

Subaortic Stenosis (SAS)

Subaortic stenosis is narrowing at the level of the aortic valve. It may be due to a discrete ridge or fibrous ring encircling the LVOT. This fibrous membrane may extend onto the aortic valve cusps and make contact with the ventricular side of the anterior mitral leaflet. The obstruction may be focal or more diffuse, resulting in a tunnel leading out of the left ventricle. The discrete form is most common. Complex subaortic stenosis can also be seen which leads to abnormal adherence to the anterior leaflet of the mitral valve to the septum and the presence of endocardial tissue in the LVOT. These type of obstructions are commonly seen in patients with ventral septal defects (VSDs).

Clinical Significance

Left ventricular outflow tract obstructions involve stenotic lesions starting in the anatomic left ventricular outflow tract and stretching to the descending portion of the aortic arch.

Obstruction can be valvar, subvalvar, or supravalvar. Obstructions to forward flow can present alone or in concert. All of these lesions result in increased afterload on the left ventricle and if severe, result in hypertrophy and eventual dilatation and failure of the left ventricle. These lesions are usually congenital in the vast majority of individuals younger than 50 years. All patients with left ventricular outflow tract obstruction at a high risk for developing infective endocarditis and prophylaxis should be instituted.

Bicuspid Aortic Valve (BAV)

Bicuspid aortic valve is one of the most common congenital cardiovascular malformations, present in about 1% to 2% of the population and more common in males. BAV can be inherited, and family clusters have been documented. In those cases, inheritance patterns are usually autosomal dominant with variable penetrance. A mutation in the NOTCH1 gene has also been described.

BAVs arise from abnormal vasculogenesis and cusp formation, resulting in the formation of 1 smaller cusp and one larger cusp. More commonly, the right and left coronary cusps are fused. BAV is usually progressive, and most valves function normally until later in life. The abnormal valve formation leads to increased leaflet stress, more turbulent flow and restricted motion which leads to accelerated valve changes including scarring, calcification, aortic stenosis, and regurgitation. BAV is associated with dilation of the ascending aorta and increased risk of aortic dissection.

Clinical Features

The most common complication of BAV is aortic stenosis.

SOURCE

Left Ventricular Outflow Tract Obstruction

Viliane Vilcant; Ofek Hai.

https://www.ncbi.nlm.nih.gov/books/NBK470446/

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