The ‘Valve Racket’: a new and different concept of atrioventricular valve repair

• Published in: European journal of cardio-thoracic surgery 2006-06, Vol.29 (6), p.1026-1029
• Main Authors: Bernal, José M., García, Iván, Morales, Dieter, Diago, Carmen, Ruiz, Blanca, Val, Fernando, Ojeda, José L., Revuelta, José M.
• Format: Article
• Language: English
• Subjects: Animal model; Animals; Biological and medical sciences; Cardiology. Vascular system; Chordae Tendineae - surgery; Disease Models, Animal; Endocardial and cardiac valvular diseases; Heart; Heart valve; Medical sciences; Mitral Valve - diagnostic imaging; Mitral Valve - pathology; Mitral Valve - surgery; Mitral Valve Insufficiency - surgery; Mitral Valve Prolapse - prevention & control; Mitral valve repair; Pneumology; Polytetrafluoroethylene; Prostheses and Implants; Prosthesis Design; Sheep; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgical Mesh; Tricuspid valve; Tricuspid Valve - surgery; Tricuspid Valve Insufficiency - surgery; Tricuspid Valve Prolapse - prevention & control; Ultrasonography
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2006.02.067

Objective: Mitral regurgitation due to prolapse of the mitral leaflets frequently compromises annuloplasty repair procedures. We present a new annuloplasty ring that overcomes this difficulty, preventing displacement of the leaflets into the atrium. Methods: The ‘Valve Racket’ is a prosthetic ring transformed into a racket by means of handmade mesh using expanded polytetrafluoroethylene (ePTFE Gore-Tex). After transection of the marginal chordae tendineae, five sheep had the new racket implanted in the mitral (n = 3) and in the tricuspid position (n = 2). The surviving sheep underwent postoperative evaluation. Results: After six months of operation, a standard transthoracic study showed competent valves without significant gradients and without residual valve regurgitation. The ring appeared encapsulated by a uniform fibrous tissue but the threads showed a completely denuded surface except in the zone proximal to the ring. Thrombi or calcification deposits in the ring, racket's mesh, or cardiac chamber were not observed. Conclusion: This initial experience confirmed the efficacy and simplicity of the technique.