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Related Experiment Videos

Cardiac valve replacement with mitral homograft.

D B Doty1, J R Doty, J H Flores

  • 1Department of Surgery, LDS Hospital, Salt Lake City, UT, USA.

Seminars in Thoracic and Cardiovascular Surgery
|January 24, 2002
PubMed
Summary

Mitral valve homograft replacement is safe but has a high early explant rate. This cardiac valve replacement is best for young patients avoiding anticoagulants or those with resistant infections.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Biomaterials in Medicine

Background:

  • Mitral and tricuspid valve disease necessitates surgical intervention.
  • Homografts are an alternative to mechanical or bioprosthetic valves.
  • Previous studies show variable outcomes for homograft valve replacement.

Purpose of the Study:

  • To review the outcomes of mitral and tricuspid valve replacement using mitral valve homografts.
  • To evaluate the safety and efficacy of homograft cardiac valve replacement.
  • To identify patient populations most suitable for homograft valve use.

Main Methods:

  • Retrospective review of 20 patients undergoing 22 cardiac valve replacements with mitral valve homografts.
  • Specific surgical techniques for mitral and tricuspid valve replacement detailed.

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  • Intraoperative echocardiography used for accuracy confirmation.
  • Concomitant Maze III procedure performed in 3 patients.

    • Main Results:

    • All 20 patients survived the operation and are alive at follow-up (up to 3.25 years).
    • Five mitral homografts (25%) and one tricuspid homograft required explantation within the first year.
    • Patients demonstrated good exercise capacity (NYHA class I).

    Conclusions:

    • Cardiac valve replacement with mitral valve homograft can be performed safely.
    • A high early explant rate indicates potential long-term competency issues.
    • Homograft use should be considered for young patients avoiding anticoagulation or those with resistant infections.