Adjustable chordae, adjustable rings
Francesco Maisano MD
disclosure• Dr Francesco Maisano is consultant for and
owns royalties and stock options of Valtech cardio
The future of mitral interventions• To innovate treatment of mitral valve disease
developing simple solutions, easy to use, reproducible, effective, in the long term
• To cross-fertilize surgical and interventional devices, to treat individuals better
• To optimize outcomes through fine tuning of the devices under physiologic conditions
To develop simple and reliable solutions,
reproducible, effective, in the long term
To cross-fertilize surgical and interventional devices, for a more
individualized treatment
To optimize outcomes through fine tuning of
the devices under physiologic conditions
The future of mitral interventions
Surgical mitral repairProven concepts
VersatilityEstablihed device designPrecision of the implant
Percutaneous repairReproducibilityImage guidance
Miniinvasive deliveryPhysiologic fine tuning
Adjustable surgical devices with image guidance featuresInterventional devices closely reproducing the surgical ones
To minimize invasivenessTo simplify the proceduresTo optimize result, always
To treat all patients
STRUCTURE vs FUNCTIONstructure function
lesion dysfunction
Minimally invasive annuloplasty: from surgical to percutaneous approach
Cardinal• MICS ring• Adjustable• Versatile (FMR, DMR)
Cardioband transatrial• Sutureless • adjustable• MICS – direct view• Transcatheter direct
approach – echo guided
Cardioband transfemoral• Percutanous delivery• Sutureless• adjustable
adjustable semirigid ring
Clinical status• Cardinal safety and
efficacy trial is completed
• CE mark pending• 22 patients treated in 3
centers• 12 pts MICS
• Device surgeon friendly• Adjustment associated
with MR and coaptation length improvement
Catego
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00.5
11.5
22.5
33.5
44.5
5
baselinepost adjustment
Sutureless surgical band• Direct transatrial access• Posterior flexible
annuloplasty band• Sutureless, adjustable• Implantable under
direct vision or echo-guidance
Percutaneous approach
Respect rather than resect• Vchordal is a sutureless
device for adjustable chordal repair– Surgical– Percutaneous
Implantation and Adjustment Handle
Helical Fixation Element, And Micro-locking Spool
SurgicalSutures
Neochordae implant made easy and effective
Conventional Image guided
Precision of implant Dynamic modulation
V-chordal clinical trial
Valtech vision of future reconstructive surgery
• Sutureless• Dynamic devices for fine
tuning• MICS• Complex repairs made
simpler• Physiologic optimization
of results
Valtech vision on percutaneous mitral valve interventions
• Devices based on solid surgical background
• Physiologic fine tuning• Early repair• High risk patients• Percutaneous MV
replacement
Beyond repair…TMVI• No radial force fixation• No perivalvular leak • No LVOT obstruction• Preservation of MV
apparatus• Safe procedure
teamwork
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