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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
PubMed
Summary
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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.

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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.