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Auto-Pericardial Mitral Valve Implantation: A Pilot Study.
Prabhu Manohar1, Rakesh Naik L1, Prasanna Simha Mohan Rao1
1Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
Heart, Lung & Circulation
|October 17, 2021
Summary
Auto-pericardial mitral valve implantation offers a safe alternative for severe mitral valve disease, avoiding anticoagulation. This procedure shows promising early results for patients needing mitral valve repair.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
Background:
- Rheumatic heart disease disproportionately affects young populations in developing nations.
- Current prosthetic mitral valve replacement necessitates anticoagulation, posing risks of thromboembolism.
- There is a critical need for alternative treatments for irreparable mitral valve disease.
Purpose of the Study:
- To evaluate the safety and efficacy of auto-pericardial mitral valve implantation.
- To assess the feasibility of using autologous pericardium for mitral valve reconstruction.
Main Methods:
- Twelve patients with severe, irreparable mitral valve disease underwent auto-pericardial mitral valve implantation.
- Autologous pericardium was treated and fashioned into mitral leaflets, sutured onto an annuloplasty ring.
- Neo-chordae were created using Gore-Tex and polyester sutures to support the reconstructed valve.
Main Results:
- The mean cross-clamp time was 138±21.7 minutes.
- Postoperative assessment showed a mean mitral valve orifice area of 3±0.47 cm² and a mean gradient of 2±1.04 mmHg.
- No patients required re-exploration or re-intervention for mitral insufficiency; postoperative regurgitation was mild (≤1+).
Conclusions:
- Auto-pericardial mitral valve re-implantation is a safe and effective option for severe mitral valve pathologies.
- Further randomized controlled trials are necessary to compare mid-term and long-term outcomes with conventional prosthetic valve replacement.
Keywords:
Auto-pericardial mitral valveBiological mitral valveIrreparable mitral valveMitral valve replacementRheumatic heart diseaseMore Related Videos
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