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CARDIOVASCULAR
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Volume 6, 2001, No 1 |
Advances
in Semilunar Heart Valve Reconstruction
J. G. Hanlon, R. W. Suggitt, J. W. Love
Background:
Ideal surgical treatment for valvular heart disease should 1) restore normal
anatomy and function with full effective orifice area, 2) use a non-calcifying
biomaterial that is durable in all age groups, 3) not require anticoagulation,
4) not use stents or other foreign bodies, and 5) offer lower costs compared
with current treatment options. Valve reconstruction with autologous tissue is
an option that potentially can achieve all 5 putative goals if the methodology
is precise and reproducible.
Materials:
Autologous pericardium treated with a brief immersion in 0.625% buffered
glutaraldehyde solution is used for reconstruction. Chemical treatment stiffens
the tissue, making it easier to handle, and it prevents the thickening and
shrinkage seen when untreated autologous tissue is used for valvular surgery.
Mechanical properties of lightly tanned autologous pericardium are excellent for
valvular applications. Most importantly, the treated non-immunogenic autologous
pericardium is resistant to calcific degeneration in experimental animals, and
in humans of all age groups.
Results:
Methods and instruments have been developed to make stentless semilunar valve
reconstruction with autologous tissue both precise and reproducible. The
instruments include a sizer to assess sino-tubular diameter, commissural
symmetry and leaflet height, an intraoperative tissue tester, a tool to cut a
precisely sized novel geometric pattern, and formers to hold the tissue in
anatomical orientation during valve reconstruction. All of the instruments are
single use and disposable, and provided in kits.
Conclusion:
Autologous tissue reconstruction of semilunar valves may achieve the goals of
ideal surgical treatment, including greater cost-effectiveness.
(CVE. 2001; 6 (1): 21-24)
Key words: heart valve, reconstruction, autologous, pericardium
Jack
W. Love, M.D., D.Phil.
785 Carosam Road
Santa Barbara
CA 93110, USA
E-mail: jwlove@cardiomend.com
PABST SCIENCE PUBLISHERS
Lengerich, Berlin, Riga, Rom,
Wien, Zagreb