[HSF] Absorbable Annuloplasty Ring

[Rwmfglycar at aol.com]

Ben,
You may know that Carlos Duran worked on this concept some time ago. For  
children the idea is appealing although as you know the children with severe  MR  
often have big hearts that will take an adult sized ring or valve so  the 
fact that the ring dissolves becomes less important.
The question of redilatation is interesting. I wrote an editorial on  this In 
the JTCVS earlier this year. A paper from Frankfurt reviewed Mural  Annulus 
Shortening Sutures followed up to 5 years. They had put the shortening  suture 
in with a rather pronounced zig zag. At 5 years some of these had  
straightened out and the annulus had redilated. This however had not been  accompanied by 
recurrence of MR. The indications for repair were up to date and  the 
patients did not have endstage ventricles. What this suggested to me was  that these 
ventricles coming to surgery were fully capable of  recovering normal systolic 
function once the Mitral leak was fixed. This  kind of case would work well 
with a dissolving ring but there are cases in which  redilatation of the 
annulus would lead to recurrence. Of course this kind of  ring does not allow 
shaping the annulus.
Bob
In a message dated 10/8/2006 11:11:00 P.M. Eastern Standard Time,  
benjamin.bidstrup at bigpond.com writes:

I  received a 'Journal' today which I was reading over lunch. There 
were a  variety of articles which are available on their website  
(http://www.hospitalmanagement.net/features/) The one that caught my  
eye was the Kalangos ring with the paper next to the ad from Bioring  
the manufacturer. It is an interesting concept especially for  
children. I would be concerned in the adult group about which we talk  
often is the potential for dilatation of the annulus once the  
polydiaxanone is resorbed. All the references are to paediatric cases  
and it is available in adult sizes.
Has anyone any views on  these?
-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic  Surgeon
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