Nova tecnologia: valvuloplastias com anéis biodegradáveis New technology: valve repair using biodegradable rings

AbstractObjective: To introduce a new concept in the annuloplastytechnology. Although rigid and flexible rings meet the basicneeds of adults, they do not preserve the changes in shapeand size occurring during the cardiac cycle. If implanted inchildren, such materials do not allow growth of the nativeannulus. Methods: From March 2003 to March 2007, 207 patientsunderwent mitral and/or tricuspid valve repair implantingpolidioxanone biodegradable rings - Bioring®. Patients weredivided 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 valvereplacement 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, 2 for valvere-repair, 5 for valve replacement. Conclusions: Biodegradable rings remodel the shape,reinforce the repair, restore the function of theatrioventricular valves and maintain the three dimensionaldynamic motion and geometry of the mitral and tricuspidvalves annulus. Growth potential is preserved in children.Although the biodegradable annuloplasty ring was firstdesigned and developed for a pediatric population, it iscurrently applied to adult cases. Children with singleventricle and AV valve incompetence are an additionalindication. The mid-term results showed that degradationof the device occurred without negative observableconsequences. Long-term results should confirm thesefindings.