Novel method of valve replacement with interrupted sutures using protractor rings for the partitioning of a prosthetic sewing ring.

Newly devised protractor rings that can equally partition a prosthetic valve sewing ring into 10-20 acrs have been used on 46 patients who underwent 59 aortic, mitral, and/or tricuspid valve replacement. After an appropriate number of interrupted mattress sutures were placed along the host annulus, one of the 11 protractor rings was chosen and used to copy the partition onto the sewing ring with a tissue pen. The interrupted mattress sutures kept on a suture holder were then passed through the prosthetic sewing ring directly from one end to the other. Based on ex vivo experiments in simulating valve replacement, it was evident that time required for placing sutures around the sewing ring was significantly shortened by the use of such protractor rings. The use of these protractor rings may thus be useful in decreasing valve replacement time as well as in potentially simplifying operative procedures.