Abstract
There is no satisfactory mitral prosthesis. We have developed a new mitral valve bioprosthesis that is 1) stentless, 2) anatomical, 3) easy to insert, and 4) economical. It consists of 1) glutaraldehyde treated autologous pericardium, 2) two different leaflets and chords 3) basal strut chords, 4) a holder to simplify its implantation, and 5) a special instrument to determine the level of chord to papillary muscle attachment. In order to check the implantation technique and competence of this prosthesis, 10 were implanted in porcine hearts held in a vertical position (5) or laid on the bench (5). Once implanted, the left ventricle was pressurized to 50, 100, and 150 mm Hg. The valve closure was satisfactory in all cases with the appearance of four leaflets without prolapse. We evaluated its performance in vivo by epicardial echocardiography after implantation of this prosthesis in 3 sheep. Valve leaflet's excursion and annulus motion appeared normal. There was no sign of transvalvular stenosis or regurgitation.TableThis prosthesis seems to perform satisfactory in vitro and in vivo. The implanting technique is reliable. Possible advantages of this prosthesis are improved hemodynamics, ease of construction and implantation, lack of immunogenicity, and low cost.
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