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J Thorac Cardiovasc Surg 2007;134:907-908
© 2007 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Discussion

Dr J. Brown (Indianapolis, Ind): Your experience with this operation is clearly the largest and the best in the world. Mr Ross, who is credited with this operation, did the autograft replacement of the mitral valve in 8 patients before the 2 of you collaborated, and then you have continued to modify his technique to make it simpler and more reproducible. The pulmonary autograft has been used in thousands of patients in the aortic valve position but in less than 150 patients in the mitral position. The autograft is the only potential durable bioprosthetic valve that is available for the mitral position. As a congenital heart surgeon, I use this operation for a select group of patients who cannot be treated with other alternatives. We have had excellent results in our small series of 8 patients with the pulmonary autograft, except in 2 or 3 patients in whom unacceptable mitral regurgitation developed because 1 of the leaflets stretched.

Do you aggressively treat systemic hypertension in your patients postoperatively to prevent stretching of the pulmonary autograft leaflets until they adapt to left ventricular systolic pressure? What is your graft material of choice to support your autograft? The woven Dacron graft that we have used in the United States has recently been discontinued. So we are looking for a woven graft that is . . . [Full Text of this Article]

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Sami Kabbani, Hisham Jamil, Fawzi Nabhani, Abdo Hamoud, Karam Katan, Nada Sabbagh, Abir Koudsi, Loay Kabbani, and Ghiath Hamed
J. Thorac. Cardiovasc. Surg. 2007 134: 902-908. [Abstract] [Full Text] [PDF]