The preclinical and clinical evidence of safety and efficacy with the BACE device (concept and feasibility) paved the way for the evaluation of the BACE device in this prospective, multi-center, single-arm, self-controlled study for safety and efficacy in the treatment of functional MR in a maximum of 60 adult subjects.

The primary efficacy endpoint will be reduction of MR grade to 1+ or less from the baseline MR grade through the 6 month study period. Primary safety endpoint will be freedom from major device and surgery-related adverse events for the duration of the 6 month follow up period. Patients will be followed up to two years.

The primary objective of this study is to assess the safety and efficacy of the BACE device for the treatment of FMR.

Secondary objective is to assess the ease of deployment of the BACE device Study Population: Since this study is to assess the safety and efficacy of a new device, with no control arm or comparator, the number of subjects enrolled will be a maximum of 60.

Approximately 8-10 sites are expected to be included in the study. The subject population is adults of 18 to 80 years of age, either gender, with FMR as specified in the inclusion and exclusion criteria.

Inclusion Criteria:

• Functional Mitral Valve Regurgitation (FMR) of moderate to severe grade (2 to 4 as per the American College of Cardiology and American Heart Association 2006 Classification of Mitral regurgitation evaluation)
• Symptomatic- NYHA Class II to IV
• Left Ventricular Ejection Fraction (LVEF) 25%-50%
• Normal mitral valve leaflets without any abnormalities and damage
• Subject is willing and available to return for study follow-up
• Surgical approach is the treatment option
• Ability of the subject or legal representative to understand and provide signed consent for participating in the study

Exclusion Criteria:

• Known hypersensitivity or allergy to the device materials
• History or presence of rheumatic heart disease
• Structural abnormality of the mitral valve (e.g. flail leaflets, ruptured or elongated chordae, prolapsed valve, perforated valve leaflets)
• Severe pulmonary hypertension, defined by pulmonary artery systolic (PAS) pressure greater than or equal to 60 mm Hg
• Grade 4 diastolic dysfunction of left ventricle on ECHO, with no change by hemodynamic maneuvers.
• ST segment [of an electrocardiogram] (ST) segment elevation myocardial infarction [MI] within 30 days of enrollment in the study; non ST segment elevation Myocardial Infarction (MI) within 7days of enrollment in the study
• Currently enrolled in another investigational drug or device study
• Subjects with intra-operative [correlate to pre-op measurement end diastolic dimension] heart circumference outside of offered BACE device size ranges [21 to 41 cm]
• Previous mitral valve surgery or other previous cardiac surgery that would preclude proper placement of the BACE
• Abnormal coronary or cardiac anatomy such that the device could not be placed without interfering with those anatomical structures
• Abnormalities in the mitral valve leaflets that would necessitate mitral valve reconstruction or replacement
• Prior Coronary Artery Bypass Graft (CABG) surgery
• Acute active infection
• Active peptic ulcer
• History of IV drug abuse
• Chronic renal failure requiring dialysis
• Creatinine > 2.5 mg/dl
• Open chest surgery contraindication [e.g., acute respiratory distress, endocarditis, myocarditis, pericarditis]
• Immune suppression therapy including corticosteroids
• Subjects with chronic connective tissue disease
• Investigator judgment that body habitus or sternal anatomy precludes pericardial access
• Females who are pregnant or lactating
• Life expectancy of < 12 months due to conditions other than cardiac status