New technology: valve repair using biodegradable rings

OBJECTIVE: To introduce a new concept in the annuloplasty technology. Although rigid and flexible rings meet the basic needs of adults, they do not preserve the changes in shape and size occurring during the cardiac cycle. If implanted in children, such materials do not allow growth of the native annulus. METHODS: From March 2003 to March 2007, 207 patients underwent mitral and/or tricuspid valve repair implanting polidioxanone biodegradable rings - Bioring®. Patients were divided into two groups: Group 1, Adults: n=121. Mean age: 48 years (± 19.2). Oldest 85 years. Group 2, Pediatric: n=86. Mean age: 9.6 years (± 4.4). Youngest 0.5 years. RESULTS: Group 1, Hospital mortality: 3.3%. Mean follow-up: 26.4 months ± 15.4. Four patients underwent mitral valve replacement 1, 2, 2 and 4 months post repair. Group 2, Hospital mortality: 1.2%. Mean follow-up: 26.7 months±13.4. Seven mitral reoperations within 1 to 24 months, two for valve re-repair, five for valve replacement. CONCLUSIONS: Biodegradable rings remodel the shape, reinforce the repair, restore the function of the atrioventricular valves and maintain the three dimensional dynamic motion and geometry of the mitral and tricuspid valves annulus. Growth potential is preserved in children. Although the biodegradable annuloplasty ring was first designed and developed for a pediatric population, it is currently applied to adult cases. Children with single ventricle and AV valve incompetence are an additional indication. The mid-term results showed that degradation of the device occurred without negative observable consequences. Long-term results should confirm these findings.