Focused Ultrasound Therapy
Focused ultrasound is an early-stage, non-invasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with mitral regurgitation (MR). This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.
The mechanism of action used is, where the beams converge, the focused ultrasound produces precise ablation (thermal destruction) of the central basal chordae, a structure which normally supports the mitral valve but can result in regurgitant blood flow after an infarction. The planned result is that cutting this structure can improve the function of the mitral valve. This work has been done in a preclinical setting, but further research will be needed before it is available for treating humans.
The primary options for treatment of MR includes medication or invasive surgical procedures.
For certain patients, focused ultrasound could provide a non-invasive alternative to surgery with less risk of complications and lower cost.
- Focused ultrasound is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- The noninvasive approach can be especially valuable since the patients may have recently had a myocardial infarction.
- It can be repeated, if necessary.
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of MR.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for MR is not yet approved by regulatory bodies or covered by medical insurance companies.
Villemain O, Kwiecinski W, Bel A, Robin J, Bruneval P, Arnal B, Tanter M, Pernot M, Messas M. Pulsed cavitational ultrasound for non-invasive chordal cutting guided by real-time 3D echocardiography. Eur Heart J Cardiovasc Imaging. 2016 Oct;17(10):1101-7. doi: 10.1093/ehjci/jew145. Epub 2016 Aug 12.
Abe Y, Otsuka R, Muratore R, Fujikura K, Okajima K, Suzuki K, Wang J, Marboe C, Kalisz A, Ketterling JA, Lizzi FL, Homma S. In vitro mitral chordal cutting by high intensity focused ultrasound. Ultrasound Med Biol. 2008 Mar;34(3):400-5. Epub 2007 Nov 7.
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