Anatomically complete heterograft mitral valve substitute: surgical technique and immediate results

The use of a totally anatomical mitral valve heterograft as a mitral valve substitute has been proven to be technically feasible. A new stentless mitral porcine heart valve substitute was therefore developed to match the physiology and flow characteristics of the left ventricle and mitral valve complex, and tested in non-survival animal experiments. Having sought the approval of the Hospital Ethics Committee and the consent of each individual patient, this valve was implanted into 18 patients with diseased mitral valves. The duration of the procedure is approximately the same as for standard mitral valve replacement. The sizing of the valve and the anchoring of the sutures to the papillary muscle, although very straightforward, do require adherence to a protocol. The immediate clinical results are encouraging, although the first patient required a reoperation because of a patient/valve mismatch. All patients, including the patient reoperated, are in functional class I after four to 26 weeks of follow up. The patients will be followed by monthly clinical and Doppler echocardiographic examinations, as they have been so far, for the next 12 months, and annually thereafter.