Surgical Experience and Long-term Results of Baroreflex Activation Therapy for Heart Failure With Reduced Ejection Fraction Fred A. Weaver, MD, William.

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Presentation transcript:

Surgical Experience and Long-term Results of Baroreflex Activation Therapy for Heart Failure With Reduced Ejection Fraction Fred A. Weaver, MD, William T. Abraham, MD, William C. Little, MD, Christian Butter, MD, Anique Ducharme, MD, MSc, Marcel Halbach, MD, Didier Klug, MD, Eric G. Lovett, PhD, Navid Madershahian, MD, Jochen Müller-Ehmsen, MD, Jill E. Schafer, MS, Michele Senni, MD, Vijay Swarup, MD, Rolf Wachter, MD, Michael R. Zile, MD Seminars in Thoracic and Cardiovascular Surgery Volume 28, Issue 2, Pages 320-328 (June 2016) DOI: 10.1053/j.semtcvs.2016.04.017 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Standardized mapping locations for carotid sinus electrode, in recommended sequence A-E on the internal carotid artery and carotid bifurcation. If no anterior location is determined to be suitable mapping may be continued on the posterior surface. (Color version of figure is available online at http://www.semthorcardiovascsurg.com.) Seminars in Thoracic and Cardiovascular Surgery 2016 28, 320-328DOI: (10.1053/j.semtcvs.2016.04.017) Copyright © 2016 The Authors Terms and Conditions

Figure 2 Illustration of carotid sinus electrode implant. An incision centered on the carotid bifurcation is made just large enough to expose the anterior surface. The mapping tool is manually guided to establish the optimal electrode location. Once determined, the electrode is fixed with sutures placed around the perimeter of the electrode backer. (Color version of figure is available online at http://www.semthorcardiovascsurg.com.) Seminars in Thoracic and Cardiovascular Surgery 2016 28, 320-328DOI: (10.1053/j.semtcvs.2016.04.017) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Trial flow diagram through 12 months of follow-up. Data were available for 57 patients randomized to BAT device plus guideline-directed medical therapy and 44 patients randomized to guideline-directed medical therapy alone. Seminars in Thoracic and Cardiovascular Surgery 2016 28, 320-328DOI: (10.1053/j.semtcvs.2016.04.017) Copyright © 2016 The Authors Terms and Conditions

Figure 4 Optimized placement of carotid sinus electrode among US trial participants (N = 37). Most electrodes are implanted in an anteromedial location adjacent to the carotid bifurcation. (Color version of figure is available online at http://www.semthorcardiovascsurg.com.) Seminars in Thoracic and Cardiovascular Surgery 2016 28, 320-328DOI: (10.1053/j.semtcvs.2016.04.017) Copyright © 2016 The Authors Terms and Conditions

Illustration of second-generation BAT electrode implant. Seminars in Thoracic and Cardiovascular Surgery 2016 28, 320-328DOI: (10.1053/j.semtcvs.2016.04.017) Copyright © 2016 The Authors Terms and Conditions