Repair of the Anterior mitral leaflet in a growing porcine model using a partially resorbable knitted patch

Mitral valve repair using patch materials is frequently limited by degeneration, inflammation, and calcification, particularly in younger patients. This study evaluated the feasibility and functional durability of a partially resorbable hybrid warp-knitted bioscaffold (Synfolium, Teijin Medical Technologies, Osaka, Japan) for mitral reconstruction in a growing porcine model. In a six-month-old Danish Landrace pig (80 kg), the mitral A2 segment was replaced with a 10 × 30 mm Synfolium patch via left thoracotomy. Postoperative echocardiography demonstrated normal valve function. After 181 days, echocardiography was repeated prior to sacrifice, followed by macroscopic inspection, histological analysis, and high-resolution micro-computed tomography (micro-CT) of the explanted valve. During follow-up, the animal grew to 159 kg. Six-month echocardiography demonstrated preserved valve function with minimal regurgitation despite a 62% increase in annular diameter. Macroscopically, the patch was fully integrated and endothelialised, with no signs of structural failure. Histology demonstrated low-grade chronic inflammation confined to suture interfaces, with no fibrosis or inflammation within the patch matrix. No calcification was identified on histology or micro-CT. In this growing porcine model, mitral leaflet reconstruction using a Synfolium patch preserved valve competence and resisted calcification over six months despite substantial cardiac growth. These findings are encouraging, although repetition of the study is required to confirm the results.