| The mitral pulmonary autograft: assessment at midterm. | |
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MedLine Citation:
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PMID: 15223403 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There is a dire need, especially in emergent societies, for a mitral substitute that does not require anticoagulation, and is not affected by early degeneration. METHODS: Between 1997 and 2003, 80 patients had successful mitral valve replacement with a pulmonary autograft. Fifty-five patients were female, and the mean age was 39.3 years. Seventy-eight patients had rheumatic mitral disease and 2 congenital. The autograft was placed inside a rigid Dacron tubing for support, and the right ventricular outflow was reconstructed with a xenograft or a homograft. Recently we have used microwave energy to ablate atrial fibrillation when present. RESULTS: Intraoperative transesophageal echocardiography revealed adequate mitral valve areas (mean area 2.76 cm2) and acceptable mitral gradients (mean 4.3 mm Hg) in all 80 patients. There was no mitral regurgitation or trace amounts in 61 patients, and mild regurgitation in 19. Operative mortality was 5.0%, and late mortality clearly related to the procedure 6.25%. Follow-up was complete except for 2 lost patients, with a mean of 25 months, and echocardiographic findings were generally stable during follow-up. One patient developed uncritical mitral stenosis and another uncritical stenosis and insufficiency during 4 to 5.5 years. Four more patients had progression of mitral regurgitation from "mild" to "moderate" over a period from 8 months to 3 years. Uncritical xenograft pulmonic stenosis developed in 2 patients. Most of the surviving patients (83%) remain in class I status. CONCLUSIONS: We believe the pulmonary autograft is a good mitral substitute at the disposal of cardiac surgeons, especially when patients are young and when life anticoagulation is contraindicated or impractical. |
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Authors:
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Sami S Kabbani; Hisham Jamil; Abdo Hammoud; Jawad Abou Hatab; Fawzi Nabhani; Ryad Hariri; Nada Sabbagh; Donald Ross |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Review |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 78 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-06-29 Completed Date: 2005-05-05 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 60-5; discussion 65-6 Citation Subset: AIM; IM |
Affiliation:
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Damascus University Cardiovascular Surgical Center, Damascus, Syria. dam-uncv@net.sy |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Atrial Fibrillation / etiology, surgery Bioprosthesis* Calcinosis / surgery, ultrasonography Child Child, Preschool Echocardiography, Transesophageal Electrocoagulation Female Follow-Up Studies Heart Valve Prosthesis* Heart Valve Prosthesis Implantation / instrumentation, methods*, mortality Humans Male Microwaves / therapeutic use Middle Aged Mitral Valve Insufficiency / complications, surgery, ultrasonography Mitral Valve Stenosis / surgery*, ultrasonography Pericardium Polyethylene Terephthalates Postoperative Complications / epidemiology, mortality Prostheses and Implants Pulmonary Valve / transplantation* Recurrence Rheumatic Heart Disease / complications, surgery, ultrasonography Transplantation, Autologous* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Polyethylene Terephthalates |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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