AUTOLOGOUS MONOCUSP PULMONARY VALVE - PRELIMINARY-RESULTS

Background. There is growing recognition that postoperative pulmonary regurgitation may result in early or late progressive right heart fail ure. Method. A technique for fashioning an autologous monocusp pulmona ry valve from the wall of the pulmonary artery was developed. The mono cusp valve was fashioned from the anterior wall of the main pulmonary artery, and the remaining defect was filled with autologous pericardiu m. The procedure was performed in 8 dogs and 5 children. Results. Earl y follow-up and serial echocardiographic assessment in both dogs and c hildren proved the functionality of this monocusp pulmonary valve. All valves were pliable and demonstrated mild to moderate pulmonary steno sis and insufficiency. Conclusions. Construction of the autologous mon ocusp pulmonary valve is a feasible technique, and the valve performs efficiently. The acute performance in the canine model was excellent, and preliminary midterm results in the clinical study are reasonable. It is logical to assume that the monocusp, being an integral part of t he arterial wall, will retain its viability and share in the subsequen t growth of the pulmonary artery. Should follow-up studies demonstrate its long-term competence, this autologous valve may provide a good so lution for various forms of pulmonary regurgitation and be useful in p ulmonary autograft replacement of the aortic valve.