Implantation technique and early echocardiographic performance of newly designed stentless mitral bioprosthesis

This article describes the implantation techniques of two new stentless mitral bioprosthesis and their early echocardiographic performance in 12 acute sheep model. The first stentless mitral bioprosthesis (stentless bileaflet valve [SBV]) was designed as a bileaflet valve with sewing ring to suture down to the native mitral annulus. The other one (SBV with chordae) has two chordae-like structures to be attached to the head of the native papillary muscles. Valvar performance and cardiac function were evaluated by epicardial echocardiography at postimplant (Rest) and during dobutamine (DOB) stimulation. Postimplant echocardiography revealed normal leaflet opening with a large orifice area and unrestricted leaflets motion. In both valves, leaflet closure showed no systolic anterior motion, prolapse, or tethering. Mitral regurgitation grade 2 or higher was not detected in any of the experiments. Transvalvar pressure gradients at Rest and DOB were 2.3 ± 1.6 mm Hg and 2.5 ± 2.2 mm Hg in SBV and 1.8 ± 1.1 mm Hg and 2.3 ± 1.2 mm Hg in SBV with chordae, respectively. Both stentless bioprosthesis showed reliable valve performance and preserved cardiac function in the acute phase. Further chronic study is needed to evaluate the reliability of implantation procedures, valvar performance, and biocompatibility.