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Quadrileaflet stentless mitral valve replacement.

T Walther1, C Walther, V Falk

  • 1Department of Cardiac Surgery, Leipzig University, Germany. walt@medizin.uni-leipzig.de

The Thoracic and Cardiovascular Surgeon
|February 12, 2000
PubMed
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The stentless quadrileaflet mitral valve (QMV) shows excellent clinical and hemodynamic results one year post-implantation. This mitral valve replacement offers promising long-term performance, potentially becoming the preferred choice.

Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Science
  • Medical Device Engineering

Background:

  • Evaluation of clinical outcomes and hemodynamic performance of the stentless quadrileaflet mitral valve (QMV).
  • Focus on one-year post-implantation results in patients undergoing mitral valve replacement.

Purpose of the Study:

  • To assess the efficacy and safety of the QMV for mitral valve replacement.
  • To analyze hemodynamic parameters and clinical status at one year.

Main Methods:

  • Implantation of 28 QMV prostheses (stentless, quadrileaflet) since August 1997.
  • Patients presented with mitral stenosis or incompetence, NYHA class III/IV, and low cardiac index.
  • Procedures included conventional or minimally invasive approaches, with additional cardiac surgeries in some patients.

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Main Results:

  • One perioperative death, unrelated to the prosthesis; all other patients discharged on time.
  • Stable hemodynamic parameters at 6 and 12 months: mean transvalvular pressure gradients around 4 mmHg and mitral valve orifice area index of 1.6.
  • Significant improvement in NYHA functional class to I or II by 12 months post-surgery.

Conclusions:

  • The QMV demonstrates suitability for mitral valve replacement, preserving anulo-ventricular continuity.
  • QMV function closely mimics native mitral valve performance.
  • Long-term data suggest the QMV may emerge as the preferred mitral prosthesis.