title: Sutureless mitral valve replacement: initial steps toward a percutaneous procedure.
abstract: OBJECTIVE
  Transcatheter mitral valve replacement would represent a major advance in heart valve therapy. Such a device requires a specialized anchoring and sealing technology. This study was designed to test the feasibility of a novel mitral valve replacement device (the sutureless mitral valve [SMV]) designed to anchor and seal in the mitral position without need for sutures.
  
  
  METHODS
  The SMV is a self-expanding device consisting of a custom-designed nitinol framework and a pericardial leaflet valve mechanism.
  
  
  RESULTS
  Ten sheep underwent successful surgical SMV device implantation. All animals underwent cardiac catheterization 6 hours postoperatively. Hemodynamic, angiographic, echocardiographic and necroscopic data were recorded. The mean aortic cross-clamp time was 9.5 ± 3.1 minutes. Echocardiography and angiography revealed excellent left ventricular systolic function, no significant perivalvular leak, no mitral valve stenosis, no left ventricular outflow tract obstruction, and no aortic valve insufficiency. Necropsy demonstrated that the SMV devices were anchored securely.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility and short-term success of sutureless mitral valve replacement using a novel SMV device.
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-5156, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gillespie
authors.forename: Masahito
authors.initials: M
authors.lastname: Minakawa
authors.forename: Masato
authors.initials: M
authors.lastname: Morita
authors.forename: Mathieu
authors.initials: M
authors.lastname: Vergnat
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Koomalsingh
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Robb
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kondo
authors.forename: Takashi
authors.initials: T
authors.lastname: Shuto
authors.forename: Manabu
authors.initials: M
authors.lastname: Takebe
authors.forename: Toru
authors.initials: T
authors.lastname: Shimaoka
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: McGarvey
authors.forename: Robert C
authors.initials: RC
authors.lastname: Gorman
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Gorman
mesh_terms: D000818:Animals; D006328:Cardiac Catheterization; D004867:Equipment Design; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D012756:Sheep; D013537:Sutures
keywords: 35
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