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Mitral valve replacement with homograft
D B Doty1, J H Flores, J R Doty
1Department of Surgery, LDS Hospital, Salt Lake City, UT, USA.
Seminars in Thoracic and Cardiovascular Surgery
|February 5, 2000
Summary
Mitral valve replacement using the Acar method with homografts is safe and reproducible. This procedure offers good short-term results and maintains normal sinus rhythm, potentially avoiding lifelong anticoagulation.
Area of Science:
- Cardiovascular Surgery
- Cardiac Transplantation
- Valvular Heart Disease
Background:
- Mitral valve homograft transplantation offers a potential alternative for valve replacement.
- The Acar method provides a specific surgical technique for mitral valve homograft implantation.
Purpose of the Study:
- To evaluate the reproducibility and safety of the Acar method for mitral valve replacement using homografts.
- To assess the clinical outcomes and functional status of patients undergoing this procedure.
Main Methods:
- Fourteen patients underwent mitral valve replacement with cryopreserved homografts using the Acar technique.
- Surgical implantation involved papillary muscle and annular suturing, supported by an annuloplasty ring.
- Intraoperative echocardiography and clinical monitoring for up to 1.5 years were performed.
Main Results:
- All fourteen patients survived the procedure and remained alive at follow-up.
- Thirteen patients maintained normal sinus rhythm; one experienced intermittent atrial fibrillation.
- One patient required reoperation due to papillary muscle dehiscence; three had moderate mitral regurgitation.
Conclusions:
- Mitral valve replacement with homograft using the Acar method is safe and reproducible.
- The procedure yields good short-term functional results and sinus rhythm maintenance.
- Routine anticoagulant therapy may not be necessary following this type of mitral valve replacement.