{"id":259,"date":"2023-12-06T15:15:48","date_gmt":"2023-12-06T15:15:48","guid":{"rendered":"https:\/\/explore.terumoaortic.com\/valsalva25\/?page_id=259"},"modified":"2025-09-23T15:55:20","modified_gmt":"2025-09-23T14:55:20","slug":"home","status":"publish","type":"page","link":"https:\/\/explore.terumoaortic.com\/valsalva25\/","title":{"rendered":"Gelweave Valsalva"},"content":{"rendered":"\t\t
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Gelweave Valsalva<\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Celebrating 25 Years<\/h1>\n

A History of GelweaveTM<\/sup> Valsalva.<\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Gelweave\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Introduction<\/span><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Since inception, as an organisation we have been committed to delivering innovative solutions that improve patient outcomes, emphasising collaboration with the clinical community.<\/p>

This 25th celebration of the Gelweave\u2122 Valsalva graft is the story of one such successful collaboration between groundbreaking surgeon led research and Scottish artisanal skill and weaving technology, brought to scale globally. The Valsalva graft, perhaps accurately described as \u2018beautifully simple, without ever being simplistic<\/strong><\/span><\/em>\u2019 has withstood the test of time, delivering hope and reliable clinical outcomes to thousands of patients and surgeons and continues to feature as key solution in the provision of operative aortic care.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Download the Pictorial History Book for the full story.<\/strong><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Pictured left: Gelweave\u2122 Valsalva being hand sewn by Kerry Lochrie in Glasgow.<\/em><\/span><\/h6>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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History<\/span><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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During the period of cultural and intellectual revival known as the
Renaissance there was a humanistic and a scientific revolution,
particularly in the fields of astronomy and anatomy. The first known
drawings and thoughts on the mechanisms at work within the aorta\u2019s Sinus of Valsalva were made in the 15th and 16th Century in the Papal States that became Italy.<\/p>

Prominent contemporary polymath Leonardo Da Vinci studied this part of human anatomy, making the notes and sketches pictured adjacently. Da Vinci\u2019s drawings and notes illustrate his understanding of how the sinuses of Valsalva contribute to the closure of the aortic valve.1<\/sup><\/p>

However, it was not until the early 18th Century that the Sinuses of Valsalva were named. Antonio Maria Valsalva (1666-1723), Professor of Anatomy at the world\u2019s oldest established University in Bologna, gave his name to this aortic landmark.2<\/sup><\/p>

Given this history of pioneering Italian research made in this part of the anatomy, it would seem very apt that a key component in its modern surgical repair would be conceived within the same lands.<\/p>

For the last 25 years, the Gelweave\u2122 Valsalva<\/span><\/strong> graft, invented by Prof. Ruggero De Paulis<\/strong><\/span><\/a> has been used to successfully treat patients suffering from conditions such as aortic dissections and root aneurysms, including those caused by genetic disorders such as Marfan Syndrome and Loeys-Dietz Syndrome.\u00a0<\/p>

This is its remarkable story.<\/strong><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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Da Vinci's notes regarding the hypothetical vascular treatment techniques<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Prof. Ruggero De Paulis<\/span><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Professor Ruggero De Paulis undertook his Cardiac Surgery training\u00a0at the University of Turin. In 1986 he completed a post-doctoral fellowship at the Artificial Heart Research Laboratory at the University of Utah, Salt Lake City.<\/p>

His research continued at a number of major European institutions while working at University of Rome – Tor Vergata, where he would go on to be appointed Associate Professor\u00a0of Cardiac surgery in 2002.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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Since 2006 he has served as Director of the Cardiac Surgery Operational\u00a0Unit at the European Hospital in Rome. In 2020 he was\u00a0appointed Professor of Cardiac Surgery, at Unicamillus University, Rome. <\/strong><\/span><\/p>

He has held 6 medical device patents, conducted over 15,000 cardiac surgical procedures and has over 300 scientific publications.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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\n\t\t\t\t\u201cAt the end of 1980s there was a great excitement when stent-less valves first became available for clinical use. In fact, compared to the stented valve, they appeared to offer great advantages in terms of reduced obstruction of the left ventricular outflow tract and especially more physiologic movements during the cardiac cycle. This was due to the possibility that a stentless valve could use the aortic root as a natural stent. It was at this timepoint\u00a0I was prompted by the chief of my resident program to study\u00a0the physiology of the aortic root in detail\u00a0to better understand the potential for this original approach.\u201d\t\t\t<\/p>\n\t\t\t\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\tProf. Ruggero De Paulis  |  Open Letter to Terumo Aortic<\/cite>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/blockquote>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Prof. Ruggero De Paulis at the grave of Antonio Maria Valsalva. <\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\u201cI embarked on reviewing a series of in vitro and in vivo studies focused on the anatomy and physiology of the aortic root.\u00a0Perhaps the most \u2018turn-key\u2019\u00a0piece of information discovered\u00a0was the realisation\u00a0that the aortic root, in contrast to the rest of the ascending aorta, expands almost exclusively in\u00a0the horizontal plane while its longitudinal compliance is almost zero.\n

\nValve sparing aortic procedures\u00a0were rarely performed during the early \u201990s. Apart from few selected cardiac centers, in the majority of cases the clinical reports were reported from the originators of the two techniques; the eminent Egyptian-British\u00a0Prof. Sir Magdi Yacoub who first described the remodeling technique and Canada\u2019s Dr. Tirone David who first described the reimplantation technique. \n

\nI witnessed their presentations and the ensuing\u00a0discussions many times during those years at major Annual Meetings. Prof. Yacoub claimed his technique was\u00a0more physiological because it re-established the sinuses of Valsalva whilst Dr. David claimed his to be more durable because it addressed the annular dilatation.\u00a0I remember being intrigued by the challenge of finding\u00a0a solution that could somehow combine the two options.\n

\nBy 1998, while assisting during a\u00a0Bentall procedure, my thinking was directed towards the need for a\u00a0material that would stretch horizontally so to fill the space previously occupied by the root aneurysm. To my knowledge, such a\u00a0material did not exist, but I was certain\u00a0a cylindrical conduit not the best solution for substituting a pear-shaped piece of anatomy.\u201d\t\t\t<\/p>\n\t\t\t\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\tProf. Ruggero De Paulis  |  Open Letter to Terumo Aortic<\/cite>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/blockquote>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Design Inspiration<\/span><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\u201cMy wife, who is a fashion designer, had been working on a peculiar womens dress completely made by pleated tissue material (pliss\u00e9 is the commonly known French word). The upper part had horizontal pleats to smoothly adapt to the shape of a narrow waist, while the lower part (corresponding to the skirt) had vertical pleats that would naturally open and close with \nthe leg movements.\n

\nI suddenly visualised the perfect shape for a Bentall procedure and the potential for providing sinuses to a David procedure. \t\t\t<\/p>\n\t\t\t\t\t<\/blockquote>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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Dr. Ruggero De Paulis and his wife Stefania Paciello.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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The dress deisgned by Stefania which inspired Valsalva\u2019s construction.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\tShe explained that the pleats were made permanent by heating up the material (I would later discover this is also how corrugated Dacron and ultimately, Gelweave is created)\u00a0 and that the only way to have pleats at a 90-degree angle to each other was to sew two different pieces of the same material together.\u00a0 \n

\nOn the kitchen table, with the help of my wife, I cut open a corrugated Dacron graft, rotated by 90 degrees and sewed it back on. \n

\nThe Valsalva graft was born...\u201d\t\t\t<\/p>\n\t\t\t\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\tProf. Ruggero De Paulis  |  Open Letter to Terumo Aortic<\/cite>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/blockquote>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Gianfranco Supino<\/span><\/span><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Mr Supino was the recipient of the the first Valsalva graft for Acute indications. During a visit to Terumo Aortic in 2020, he remarked the following:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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\n\t\t\t\t\u201cWhat I can tell you is that the quality of my life has been fully preserved. After less than 20 days I was able to restart working without any medical difficulty. After 1 month I was able to restart my workout, not so intense of course but I was able to recover that important piece of my life. After 6 months roughly, I was back to my normal life.\u00a0\n

\nInitially the requirement for surgery was an \u2018earthquake\u2019 needless to say, but after that event I can tell you my life has dramatically improved because of the value I give to each single day is higher than the value I used to give prior.\n

\nYou cannot imagine the complexity, the art, the magic which is behind those artifacts (grafts). In my chest there is now a jewel beating somehow, together with my heart. It was wonderful to visit Terumo Aortic and see the sewing team investing so much of their time making the grafts perfect because they can save lives and allow normal life to continue.\u201d\n\t\t\t<\/p>\n\t\t\t\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\tGianfranco Supino during visit to Terumo Aortic Glasgow in 2020<\/cite>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/blockquote>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Global Impact<\/span><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Aortic Dissection accounts for 3 out of every 1000 emergency department presentations involving acute chest, back, or abdominal pain. 3<\/sup><\/p>

The condition predominantly affects individuals between 40 and 70, with most cases occurring in patients aged 50 to 65. Approximately 75% of dissections happen in this age range, highlighting age as a key risk factor. 3<\/sup><\/p>

While men are 3 times more likely to develop aortic dissection than women, women often present later in the disease course and have worse outcome. 3<\/sup><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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\n\t\t\t\t\t