For Surgeons "Partial" to Flexibility

Use of an annuloplasty band while maintaining strength and flexibility is considered a benefit by surgeons based on the following rationale:

• Approximately 80 percent of mitral valve repairs are for degenerative disease occurring predominantly to the posterior portion of the mitral annulus; therefore, surgeons may choose a band that supports only the dilated posterior annulus. [Duran CMG,Odell]
• Visibility and access to the anterior portion of the mitral annulus may be limited in some cases. [Odell] A band may be easier to implant in certain clinical situations when the surgeon feels there is not a need to add support to the anterior portion of the annulus.
• Use of a band in the tricuspid position helps avoid possible damage to the conduction system that is located very close to the insertion of the anterior portion of the septal leaflet. [Duran]
• Increasingly, chords are being replaced with sutures. Most surgeons tie the sutures to the leaflets after the annuloplasty has been performed, which requires passing the sutures through the annuloplasty ring. Use of a band allows the surgeon to place the sutures anteriorly while suturing the band in place. [Duran]
• Mitral valve reconstruction for myxomatous disease offers excellent results. [Gillinov]

Sufficient Band Length

The Duran AnCore Band extends beyond the trigones to provide secure suturing to the trigones.

Ease of Implant

The Duran AnCore Flexible Annuloplasty Band encompasses both performance and practicality. The radiopaque band is mounted on a blue holder that maintains its natural systolic shape during suture placement and knot tying. Additional components designed to make the Duran AnCore Band easier to implant are packaged separately:

• The clear, plastic suture template features reference guides to facilitate suture placement and visibility.
• Polysulfone resterilizable sizers are shaped like the template.
• A malleable, surgical stainless steel, resterilizable handle fits both template and sizers and is available in 216 mm and 373 mm lengths to accommodate surgical technique.

REFERENCES

1. Duran CMG. Duran Flexible Annuloplasty Repair of the Mitral and Tricuspid Valves: Indications, Patient Selection, and Surgical Techniques Using the Duran Flexible Annuloplasty Ring. Medtronic, Inc. 1992.
2. Odell JA, Schaff HV, Orszulak TA. Early Results of a Simplified Method of Mitral Valve Annuloplasty. Circulation 1995;92 (Suppl 2):11-150-4.
3. Duran In-Service Guide. Medtronic, Inc.
4. Personal Communication with Dr. Carlos Duran.
5. Gillinov AM, Cosgrove DM, Blackstone EH, et al. Durability of Mitral Valve Repair for Degenerative Disease. J Thorac Cardiovasc Surg 1999;117:472-80.