title: Quadrileaflet stentless mitral valve replacement.
abstract: BACKGROUND
  The study evaluates clinical results and hemodynamic parameters one year after implantation of a stentless quadrileaflet mitral valve (QMV).
  
  
  METHODS
  Since August 1997 28 patients received the QMV, patient age was 69 +/- 8 years; 13 had predominant mitral stenosis and 15 incompetence, preoperative NYHA functional class was III or IV and cardiac index 1.8 +/- 0.6 L/min/m2.
  
  
  RESULTS
  Surgery was performed using a conventional (25) or a minimally invasive approach (3). 20 patients received a medium and 8 a large-size prosthesis, crossclamp time was 58 +/- 19 min. Additional procedures were myocardial revascularization in four, tricuspid repair in two, and left-atrial radiofrequency ablation to restore sinus rhythm in six patients. Perioperative mortality (1) was not valve-related. All other patients were discharged on time. At postoperative, 6-, and 12-months follow-up mean transvalvular pressure gradients were 4.2 +/- 1.5 / 4 +/- 0.9/ 3.8 +/- 1.4 mmHg and mitral valve orifice area index was 1.5 +/- 0.3 / 1.6 +/- 0.3 / 1.6 +/- 0.4, NYHA class was I or II.
  
  
  CONCLUSIONS
  The QMV is well suited for mitral valve replacement. The anulo-ventricular continuity is preserved and the QMV function resembles native mitral valve function. If its performance is maintained in the long term the QMV may be the mitral prosthesis of choice.
authors.affiliation: Department of Cardiac Surgery, Leipzig University, Germany. walt@medizin.uni-leipzig.de
authors.forename: T
authors.initials: T
authors.lastname: Walther
authors.forename: C
authors.initials: C
authors.lastname: Walther
authors.forename: V
authors.initials: V
authors.lastname: Falk
authors.forename: G
authors.initials: G
authors.lastname: Langebartels
authors.forename: M
authors.initials: M
authors.lastname: Krüger
authors.forename: A
authors.initials: A
authors.lastname: Dagge
authors.forename: A
authors.initials: A
authors.lastname: Diegeler
authors.forename: R
authors.initials: R
authors.lastname: Autschbach
authors.forename: F W
authors.initials: FW
authors.lastname: Mohr
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008943:Mitral Valve; D011474:Prosthesis Design; D013997:Time Factors