PARTIAL MITRAL-VALVE REPLACEMENT WITH A MITRAL HOMOGRAFT IN SUBACUTE ENDOCARDITIS

In a case of subacute endocarditis, the diseased parts of the mitral v alve were replaced by the corresponding parts of a mitral valve homogr aft. This technique was studied experimentally in animals in the sixti es and seventies, but was never performed clinically on a large scale in humans. By preserving a functional papillary muscle and chordae ten dinae complex, ventricular function is more efficient than in the case of replacement of the valve by a prosthesis. The absence of any prost hetic material in an infected area also decreases the possibility of r einfection. In performing this type of operation, surgical pit falls s uch as fistulas at the region of the annulus, dehiscence of papillary muscle, or rupture of the chordae tendinae have to be avoided. Surgeon s have to be supplied with high-quality homograft valves of different sizes to obtain optimal hemodynamic results.