HETEROLOGOUS MITRAL-VALVE TRANSPLANT - THE 1ST 50 PATIENTS CLINICAL ANALYSIS

From March 1992 to August 1993, 50 patients underwent mitral valve rep lacement with the new heterologous stentless mitral bioprosthesis in o ur institution. The development of this heart valve substitute, its te chnique of implantation and the results observed in the first group of 50 patients have had us to review the initial experience. The surgica l protocol included an accurate mitral valve complex analysis, adequat e valve size selection, attachment of the papillary muscle to the new chordal origin and approximation of the stentless mitral to the patien t's annulus. There was one hospital death (2%), not related to the val ve or to the technique and four reoperations: two due to endocarditis, one because of a perivalvular leak and one due to a mismatched stentl ess valve. The late mortality (4%) was not valve-related. The follow-u p has shown excellent valve performance with improved left ventricular function in the great majority of the patients. Based on the current analysis, it can be stated that reproducibility of the surgical techni que and the excellence of the clinical follow-up may contribute favora bly to a better quality of life and longer valve durability in patient s requiring mitral heart valve replacement.