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Related Experiment Videos

Tissue valves in the mitral position. Five years' experience.

D A Mary, B C Pakrashi, R W Catchpole

    British Heart Journal
    |November 1, 1975
    PubMed
    Summary

    This study compared three-cusp stented tissue valves for mitral replacement. Homologous fascia lata and heterologous pericardium showed better outcomes than autologous fascia lata, with lower complications and good long-term survival.

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    Area of Science:

    • Cardiovascular Surgery
    • Biomaterials Science

    Background:

    • Mitral valve replacement is a critical cardiac procedure.
    • Tissue valve durability and performance are key concerns for long-term patient outcomes.

    Purpose of the Study:

    • To evaluate the early and late outcomes of isolated mitral replacement using three-cusp stented tissue valves constructed from autologous fascia lata, homologous fascia lata, and heterologous pericardium.
    • To compare the efficacy and safety of these different biomaterials in mitral valve surgery.

    Main Methods:

    • A retrospective analysis of 103 patients undergoing isolated mitral replacement between April 1969 and November 1973.
    • Patients received valves made from autologous fascia lata (n=50), homologous fascia lata (n=21), or heterologous pericardium (n=32).
    • Follow-up ranged from 8 to 60 months, with analysis of early and late mortality, valve failure, infective endocarditis, mitral regurgitation, thromboembolism, and survival rates.

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    Main Results:

    • Early mortality was 14.6%, influenced by patient age, preoperative cardiac disability, and low cardiac output.
    • Late mortality was 13.6%, with high preoperative pulmonary artery pressure as a significant factor.
    • Autologous fascia lata valves showed significantly higher rates of valve failure and infective endocarditis.
    • Homologous fascia lata and heterologous pericardium valves demonstrated significantly lower rates of postoperative mitral regurgitation, with no graft removals required.
    • Low incidence of thromboembolism was observed without anticoagulation.
    • Actuarial survival at five years was 82.2%.

    Conclusions:

    • Autologous fascia lata is no longer used for mitral valve prostheses due to poor outcomes.
    • Homologous fascia lata and heterologous pericardium offer superior results compared to autologous fascia.
    • Heterologous pericardium is preferred due to its favorable physical characteristics and availability, despite comparable results to homologous fascia.