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IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
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IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
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The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
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The first successfully cloned mammal was Dolly, a sheep, born on 5th July 1996 at Roslin Institute, Scotland. The cloned sheep was named after the American singer Dolly Parton. Dolly lived for seven years and died of respiratory complications, which is speculated to be due to the actual age of her DNA. Because the DNA in cloned cells belongs to an older individual,  the cloned individual’s life expectancy may be affected. Indeed, analysis of Dolly’s DNA revealed shorter...
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The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Decellularized mitral valve in a long-term sheep model.

Pavel Iablonskii1,2, Serghei Cebotari1, Anatol Ciubotaru1

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European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|February 1, 2018
PubMed
Summary

Decellularized mitral valves (DMVs) show superior long-term performance and less degeneration compared to biological mitral valves (BMVs) in a sheep model. Surgical implantation of DMVs is feasible, offering a promising alternative for mitral valve repair.

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Area of Science:

  • Biomaterials Science
  • Cardiovascular Surgery
  • Tissue Engineering

Background:

  • Degenerative valvular heart disease necessitates advanced prosthetic solutions.
  • Decellularized allografts offer a promising alternative to traditional bioprosthetic valves.
  • Evaluating the long-term performance of decellularized mitral valves (DMVs) is crucial for clinical translation.

Purpose of the Study:

  • To assess the surgical handling, in vivo hemodynamic performance, and morphological characteristics of DMVs.
  • To compare the long-term outcomes of DMVs against stented porcine aortic valves (biological mitral valves, BMVs) in a sheep model.

Main Methods:

  • Ovine mitral valves underwent decellularization using detergents and β-mercaptoethanol.
  • Orthotopic implantations were performed in sheep, with BMVs used as controls.
  • Valve function was assessed via transesophageal echocardiography and explant histology.

Main Results:

  • DMVs demonstrated feasible surgical implantation with good early function.
  • At 12 months, all BMVs showed severe degeneration, calcification, and leaflet issues.
  • DMVs exhibited no calcification or stenosis, with only trivial to moderate regurgitation and evidence of endothelialization.

Conclusions:

  • Decellularized mitral valves exhibit a superior degenerative profile compared to commercial porcine aortic prostheses.
  • Surgical implantation of DMVs is feasible, though further research is needed to minimize complications and improve reproducibility.
  • DMVs represent a promising alternative for mitral valve replacement, outperforming current biological options in long-term durability.