Clinical and Hemodynamic Performance of a Totally Flexible Prosthetic Ring for Atrioventricular Valve Reconstruction

Mitral valve repair with a malleable bovine pericardium ring

“…Long-term results showed ventricular function restored to normal levels, significantly improved survival ratios in particular following solely mitral procedures 34 , which in the present work were performed in 71.8% of the patients. Associated with this was the introduction of various valve repair techniques 13,21,40,41 as well as recognition of the problems caused by valve replacement procedures like prosthesis degeneration, infection, transvalvular gradients, paravalvular leaking, hemolysis, and thromboembolic events 8,37 .…”

“…These techniques started to be used together with annuloplasty for recovery of valve function 7,12 . Accumulated experience and new concepts about the physiology of the mitral valve apparatus showed the limitations of this technique, such as fixation of the contractile annulus 13,14 and eventual obstruction of left ventricle outflow [15][16][17][18][19] .…”

“…Complete rings developed by Duran et al 13,20 and by Puig et al 21,22 followed principles similar to these proposed by Carpentier and colleagues, with the advantage of flexibility respecting native annulus motility 13,[20][21][22] , and reduction of possible obstruction of left chamber outflow tract 23 . Yet, the anterior valve annulus does not participate, to an expressive extent, in the dilatation of the mitral apparatus, and the placing of a complete annular prosthesis may distort it, harming the left ventricleoutflow tract.…”

“…Valve repair techniques using rings are based on the anterior leaflet area, associated or not with intertrigonal or intercommissural distances for the selection of annular prosthesis size 10,13,[27][28][29][30] . In 1985, Braile et al 26 developed specific measuring devices aimed at the evaluation of the anterior cusp perimeter, thus introducing a new concept for the choice of annular prosthesis size.…”

Estudo comparativo do anel valvar mitral e do ventrículo esquerdo na cardiomiopatia dilatada

“…DURAN & UBAGO (23) desenvolveram um anel protético totalmente flexível para reconstrução do anel valvar atrioventricular esquerdo, restaurando o anel ao seu tamanho e forma normais, respeitando as mudanças do anel valvar durante o ciclo cardíaco.…”