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J Thorac Cardiovasc Surg 2004;127:1527-1529
© 2004 The American Association for Thoracic Surgery

Brief communication

Orthotopic mitral valve replacement with autologous pulmonary valve in a porcine model

^a Departments of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, NY, USA
^b Departments of Pediatrics, Mount Sinai Medical Center, New York, NY, USA

Received for publication July 11, 2003; accepted for publication November 17, 2003.

^* Address for reprints: Khanh Nguyen, MD, Pediatric Cardiac Surgery, Department of Cardiothoracic Surgery, Mount Sinai Medical Center, Box 1028, 1190 Fifth Ave, New York, NY 10029, USA
Khanh.Nguyen@mountsinai.org

The first 20% of the full text of this article appears below.

Mitral valve replacement in children continues to be a challenge because of the unavailability of an ideal prosthesis. Although most patients can have a successful palliation with repair, some need valve replacement.

In the 1960s, Willman and colleagues¹ made early attempts to place a semilunar valve in the orthotopic mitral position in dogs. Subsequent work involved implantation of a semilunar valve homograft or autograft in a supra-annular location in a special configuration called a top hat.² However, the limitation of growth inherent in this approach makes it less attractive in the pediatric population.

We have begun to investigate the possibility of implanting the pulmonary valve orthotopically in the mitral position (Figures 1 and 2). This approach retains the freedom from anticoagulation and the durability that make the top hat operation attractive but also permits growth, because there is no physical constraint from the top hat supporting tube. This report presents preliminary data in a short-term study in a porcine model on the feasibility of orthotopic mitral valve replacement with an autologous pulmonary valve.

View larger version (39K): [in this window] [in a new window]   Figure 1. A, Pulmonary autograft is implanted in orthotopic mitral position. Pulmonary artery end of autograft is anchored to tips of papillary muscles. B, Ventricular end of autograft is anastomosed to hinge area of native mitral valve. C, Autologous pulmonary valve in orthotopic . . . [Full Text of this Article]

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