Experience with homograft mitral valve replacement.

BACKGROUND AND AIMS OF THE STUDY

Homograft mitral valve replacement may offer a superior alternative to replacement with a prosthetic valve. The authors' early experience with this technique is reported.

METHODS

Between May 1994 and May 1995, 24 patients (19 males, five females; age range 17 to 49 years) underwent homograft mitral valve replacement (HMVR) at the authors' institution. The etiology was rheumatic in all patients; 22 had severe calcific mitral stenosis (MS) and two had combined MS and severe mitral regurgitation (MR).

RESULTS

There were three early deaths (12%) and two late deaths (8%). In three patients the homograft had to be explanted due to severe MR at six weeks, 10 weeks and 12 months, respectively. Mean follow up was 18 months (range: 12 to 25 months). Postoperative echocardiography showed trivial or mild MR in 12 patients and moderate MR in four. Mitral stenosis was absent in all patients (mean mitral valve area 2.5 cm2). Sixteen patients showed satisfactory homograft valve function at follow up. The valve explanted after six weeks showed normal cusp architecture, endothelial growth and incorporation of the pericardial strip and complete healing of the papillary muscle junction. Magnetic resonance imaging in 12 patients showed normal appearance and function of the homografts.

CONCLUSIONS

The authors' experience suggests that homograft mitral valve replacement can be performed with good early results.