SURGICAL TECHNIQUE OF IMPLANTING THE STENTLESS PORCINE MITRAL-VALVE

The new stentless porcine mitral valve was developed to serve as an an atomically correct substitute for a diseased mitral valve. Extensive a cute animal experimentation was performed, and from this the logical s equence for selecting the correct valve size and the specific techniqu e for implanting it were determined. The following are the major steps to successfully implant a mitral stentless valve: First, mitral valve complex analysis must be done to determine the correct procedure to b e performed and the feasibility of using the stentless mitral valve. S econd, the correct size of stentless mitral valve must be chosen. Thir d, the papillary muscle anatomy must be assessed to determine the site and number of sutures necessary for securely holding the new origin o f the new chordae. Fourth, the papillary muscle sutures must be anchor ed to the free pericardial edge of the new chordal origin. Fifth, the chordal alignment with both trigonal areas must be perfect. Sixth, the annulus may be sutured using either continuous or interrupted sutures . Perioperative echocardiography, preferably transesophageal echocardi ography, should be done in every patient. Although reoperation was nec essary in 5 patients (non-valve-related), the results in 74 patients ( 3 early and 3 late non-valve-related deaths excluded) followed up for at most 26 months (mean, 14 months) have been excellent. The quality o f the results obtained in this initial clinical trial has reinforced o ur current preference for this valve in patients requiring mitral valv e replacement. Longer follow-up is required to confirm that these good results continue.