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J Thorac Cardiovasc Surg 2005;129:677-679
© 2005 The American Association for Thoracic Surgery

Brief Communications

A method of using the pulmonary trunk to form a trileaflet valve

^a Division of Cardiac Surgery
^b Department of Cardiology, Massachusetts General Hospital, Boston, Mass
^c Institut d' Anatomie, UFR Biomédicale des Saints-Péres
^d Department of Cardiovascular Surgery
^e Cardiology, Hôpital European George Pompidou
Département de Chirurgie Cardio-vasculaire, Hôpital Broussais, Paris, France

^* Address for reprints: Jennifer K. White, MD, Division of Cardiac Surgery, Massachusetts General Hospital, Bullfinch 119/50 Fruit St, Boston, MA 02114 (E-mail: jkwhite@partners.org).

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

Dr White

Replacement heart valves constructed from autologous tissues have been attempted, with significant variations in long-term leaflet pliability and cellular viability.^1-3 A new method of creating a potentially viable trileaflet valve from autologous pulmonary artery was investigated.

	Materials and methods

 
Human anatomic study
Using cadavers (n = 7), the main pulmonary trunk was removed and trimmed to create a tissue cylinder with a height equal to the corresponding aortic annulus diameter (Figure 1, A). Three longitudinal incisions, 2 mm less than one half the cylinder height, were positioned 120° apart (Figure 1, A). The resulting flaps were involuted and secured 2 to 3 mm from the superior rim of the cylinder with 6-0 polypropylene (Prolene; Ethicon, Inc, Somerville, NJ) sutures passed through adjacent flaps near their free edges and tied, making each a U stitch (Figure 1, B-D). The base of the involuted tissue was joined with additional 6-0 polypropylene sutures, creating interleaflet triangles and eliminating acute corners from the inner surface of the valve (Figure 1, E). The outermost wall was scalloped (Figure 1, D and E).

View larger version (35K): [in this window] [in a new window]   Figure 1. Involution method of valve construction and surgical implantation. A segment . . . [Full Text of this Article]

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