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

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11.5

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44.5

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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