Stentless mitral valve replacement by conventional and minimally invasive techniques.
Stentless mitral valve (SMV) replacement is an intriguing concept to preserve the functionality of the physiological mitral valve (MV). Beginning in August 1997 to date, 51 patients, 35 females and 16 males (age: 68.3+/-8.4 years), with severe MV disease (stenosis 25, incompetence 17, mixed lesion 9) received a chordally supported SMV. SMV implantation was performed using a conventional sternotomy in 32, or a minimally invasive lateral minithoracotomy approach in 19 of the patients. Mean valve size was 29+/-1.5 mm; cross-clamp duration was 81+/-33 min. The perioperative mortality rate was comparable to conventional MV repair or replacement. Regular echocardiographic control disclosed good SMV function (Vmax 1.7+/-0.2 m/s, Pmean 3.9+/-1.2 mmHg) and well-preserved ejection fraction postoperatively, as well as at their most recent follow-up visit. SMV implantation by way of a sternotomy or lateral minithoracotomy leads to preservation of the annulo-ventricular continuity and similar to physiological hemodynamics. However, long-term durability remains to be proven.
Walther
Thomas
T
Universität Leipzig, Herzzentrum, Klinik für Herzchirurgie, Leipzig, Germany.
Lehmann
Sven
S
Falk
Volkmar
V
Mohr
Friedrich W
FW
D000368:Aged; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery*; D013908:Thoracotomy; D016896:Treatment Outcome