Document Detail


Mitral valve replacement with the pulmonary autograft: midterm results.
MedLine Citation:
PMID:  19619779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We performed mitral valve replacement with a pulmonary autograft using the technique described by us earlier and present the results. METHODS: Between August 2000 and July 2007, 19 patients (16 male patients; age, 30-58 years) with isolated calcific mitral stenosis (n = 16) or mixed mitral stenosis and regurgitation (n = 3) underwent mitral valve replacement with a pulmonary autograft. Sixteen patients were in New York Heart Association class III and 3 were in New York Heart Association class IV preoperatively. Eight patients were in atrial fibrillation. The autograft implantation was achieved by using a scalloped stent of polytetrafluoroethylene felt for external support of the autograft. No anticoagulants were prescribed. RESULTS: There were 3 early deaths, one each caused by ventricular dysfunction, ventricular arrhythmias, and autograft dehiscence requiring early reoperation. Follow-up of survivors ranged from 34 to 99 months (mean, 71.9 +/- 18.2 months; median, 75 months). The mean valve area was 2.96 +/- 0.9 cm(2) (range, 2.2-4.3 cm(2)). Fourteen survivors are in New York Heart Association class I, and 2 are in NYHA class II; 4 continue to be in atrial fibrillation. Follow-up echocardiograms (n = 16), magnetic resonance imaging (n = 6), and cardiac catheterization (n = 4) have demonstrated no significant autograft and pulmonary homograft dysfunction. There were no late deaths or reoperations or thromboembolic complications. CONCLUSIONS: Mitral valve replacement with a pulmonary autograft, a complex operation, can be performed in selected patients with acceptable results. The use of our technique of autograft implantation offers several advantages and avoids exposure of the scaffold to the bloodstream.
Authors:
Arkalgud Sampath Kumar; Sachin Talwar; Anubhav Gupta
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Publication Detail:
Type:  Journal Article     Date:  2009-03-26
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  138     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-21     Completed Date:  2009-07-30     Revised Date:  2010-01-29    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  359-64     Citation Subset:  AIM; IM    
Affiliation:
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India. asampath_kumar@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Calcinosis / surgery
Cardiac Surgical Procedures / adverse effects,  mortality
Disease-Free Survival
Female
Hospital Mortality
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Stenosis / etiology,  physiopathology,  surgery*,  ultrasonography
Pulmonary Valve / transplantation*
Reoperation
Rheumatic Heart Disease / complications
Transplantation, Autologous
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2010 Jan;139(1):237; author reply 237-8   [PMID:  20106371 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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