What If There Was a Way to treat Heart Failure (HF) Patients without Opening Their Chest? There Is, and BioVentrix Is Making It Possible

In the US and EU, HF is one of the most frequent diagnoses, and accounts for 7.5 million hospital days per year. Three to five percent of patients die despite hospitalization, half go home unimproved, 25% are readmitted within 30 days, and 30% die in six months. The data indicates the market is 2 million cases representing an $18B market growing at a rate of 13% annually.

A “heart attack” — not the same thing as “heart failure” (HF) — turns heart muscle into scar. It is the scar that leads to HF, and is the underlying problem in about 70% of all HF cases (known as “ischemic cardiomyopathy”), making the heart enlarged and working inefficiently.

San Ramon, Calif.-based BioVentrix has received CE marking for its Revivent™ Myocardial Anchoring System, which makes possible Less Invasive Ventricular Enhancement™ (LIVE™), a procedure that restores the left ventricle from damage done by a heart attack to a more optimal volume and conical shape, thereby enhancing performance of the heart’s non-damaged myocardium and improving quality of life.

Prior to Revivent™, reshaping of the left ventricle required an invasive procedure known as surgical ventricular restoration (SVR), which required stopping the beating heart and supporting it with cardiopulmonary bypass, while significant incisions into the heart muscle are made to excise the scarred, non-functioning (ischemic) ventricular tissue. The invasive nature of SVR limits the number of patients for whom the procedure may be performed due to the fragile nature of this patient population. In contrast, the less invasive LIVE™ procedure using the Revivent™ system is performed without the need of cardiopulmonary bypass or making incisions into the heart.

“Heart failure in Europe is more common than most cancers,” said Louis Labrousse, M.D., professor of Cardiovascular Surgery at Hopital Haut-Lévêque, Bordeaux-Pessac, France. “Prior to the availability of Revivent, open-heart surgery could only be applied sparingly among this very fragile patient population due to its invasiveness. There are some 14 million people in Europe who currently suffer from heart failure. Unfortunately, this number is expected to more than double by 2020. Thus, regulatory approval of Revivent is significant news for ischemic heart failure patients throughout Europe.”

“Because of Revivent, the LIVE procedure can be performed without cardiopulmonary bypass: therefore the heart is beating and stable, and there is no major surgical incision in the myocardium,” added Andrews S. Wechsler, M.D., professor of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia. “Intraoperative monitoring has documented the excellent hemodynamics present at the end of the LIVE procedure without vasoactive support. No doubt, regulatory approval of Revivent will have a significant impact on the treatment of heart failure patients in Europe going forward.”

“Our innovative Revivent system used during LIVE procedures will empower cardiac surgery teams not only to ensure optimal clinical outcomes and enhance quality of life for heart failure patients but also to minimize risk compared to the previous gold standard of conventional left ventricle reconstruction surgery,” said Kenneth Miller, president and chief executive officer of BioVentrix. “While we are extremely pleased with the regulatory approval of Revivent in Europe, we are also looking forward to our next-generation Revivent technology — transcatheter ventricular restoration (TCVR),” added Miller. “Given the successful clinical outcomes we have achieved with Revivent, we have fast-forwarded development of our next-gen, endovascular technology designed to achieve the same results as the LIVE procedure, but with a sternal-sparing technique. This closed-chest, beating heart, transcatheter therapy is expected to be a new paradigm for treating heart failure patients, holding great promise for those who have suffered a heart attack but are just too sick to tolerate invasive heart surgery.”

The Revivent™ Myocardial Anchoring System addresses the safety concerns of physicians about subjecting patients to invasive surgical interventions on the heart’s left ventricle. Made possible by the Revivent system, the LIVE™ procedure can be performed as a separate stand-alone procedure, concurrent with other procedures (e.g., CABG) or during other occasions when a sternotomy is already employed. Neither a myocardial incision nor cardiopulmonary bypass is required. Additionally, the Revivent system is deployed using a straightforward, epicardial approach that can be completed in about one hour.

The forthcoming transcatheter version of Revivent is designed for use by a hybrid team of cardiac surgeons and cardiologists. Given the successful clinical outcomes achieved with Revivent™, BioVentrix is developing next-gen, nonsurgical technology to achieve the same results as the LIVE procedure, but with a sternal-sparing technique — transcatheter ventricular restoration (TCVR). This closed-chest, beating heart, transcatheter therapy is designed to be a game-changer, according to BioVentrix management, holding great promise for patients who have suffered a heart attack but are just too fragile to tolerate invasive heart surgery.