THE AUTOLOGOLUS TISSUE CARDIAC-VALVE - A NEW PARADIGM FOR HEART-VALVEREPLACEMENT

This is a report of early clinical experience with an autologous tissu e cardiac valve, which demonstrates the feasibility of making a biopro sthesis in the operating room in 10 minutes at the time of the valve r eplacement operation. There were 30 implant patients (18 men, 12 women ), with ages ranging from 32 to 83 years. Diagnoses included calcified aortic stenosis (n = 16), pure aortic insufficiency (n = 9), and mixe d aortic stenosis and insufficiency (n = 5). Associated diagnoses have included chronic renal failure treated with dialysis (n = 1), coronar y artery disease requiring concomitant coronary bypass (n = 1), ascend ing aortic aneurysm requiring resection (n = 3), and mitral insufficie ncy requiring concomitant mitral valvuloplasty (n = 2). All of the val ve replacements were in the aortic position. These implanted patients are being followed up carefully according to the protocol that require s examination every 6 months for the first year and every 12 months su bsequently. No patient has been lost to follow-up. Twenty-seven patien ts are alive and well from 1 to 22 months postoperatively. There were three deaths: two perioperative deaths (one perivalvular leak and one hemorrhage) and one infective endocarditis 1.3 years after valve repla cement. All surviving patients were followed up by echocardiographic e xamination (mean gradient, 15.5 +/- 6.8 mm Hg at 1 year). In conclusio n, the feasibility of this method and concept has been demonstrated wi th implants in 30 patients. The validity of the technique will be judg ed by clinical results and experiences in children.