PMID: 2121389Nov 1, 1990Paper

Absorbable rings for pediatric valvuloplasty. Preliminary study

Circulation
J C ChachquesA Carpentier

Abstract

Secondary valvular stenosis is a significant risk of annular ring implantation during valvular repair in children. To avoid this problem, we have developed an absorbable prosthetic ring (APR), which induces the generation of a biologic fibroelastic ring with mitotic capability and thereby allows atrioventricular annulus growth with age. Twelve polydioxanone (PDS) biodegradable APRs were surgically implanted in immature goats. To avoid possible embolic complications from ring fragments during the absorption period, APRs were covered with an extensible sewing sheath of high-porosity polyester, allowing contact between the PDS, blood, and endocardium. Four APRs were implanted into the right atrial cavity, four in the tricuspid position, and four in the mitral position. Histological studies at 6 months showed a considerable amount of remaining PDS. At 1 year, only small residual fragments of PDS were present, surrounded by collagen and elastic fibers as well as fibroblasts with mitotic activity. This histological structure represents a new biologic fibroelastic ring, which has originated from PDS rings. Echocardiography at 12 months showed that the elasticity of APRs and fibrotic tissue allows normal systolic and diastolic valve mo...Continue Reading

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