The performance of three fascia lata valves in aortic position, a Sterling-Edwards, a Ionescu and a valve of our design, was compared in a test chamber with that of a Starr-Edwards valve. Pulsatile pressures and flows of shapes and magnitudes similar to in vivo conditions at the left ventricular and aortic levels were provided by a pulse duplicator system. Mean values ± 1 SD of measurements made on 10 successive strokes of the Starr-Edwards valve were the following: mean total pressure gradient (ΔPv–a): 5.0 ± 0.4 cm H2O, approximated energy loss (E): 269, 530 ± 19,440 erg/stroke, instantaneous energy loss (E): 247,040+10,600 erg/stroke and backward flow (Qbf): 1.3 ± 0.3 ml. The same results for the Sterling-Edwards, the Ionescu and the fascia lata valve of our design, expressed in percent of the Starr-Edwards mean values were respectively for ΔPv–a: 136, 182 and 66%; for 1: 147, 160 and 65%; for E: 208, 215 and 60%; and for Qbf: 131, 308 and 477%. The valve of our design was, therefore, shown to present a significantly smaller loss of energy but a more important backflow.
A new technique is described using homologous fascia lata for the construction of an aortic valve without prosthetic support and resulting in the simple and rapid production of the valve. The latter is nearing normal anatomical and physiological conditions. The successful use of such a valve in a case of acute bacterial endocarditis is described.
A case of double inlet right ventricle in which both atrioventricular valves opened completely into the right ventricle is described. The left atrium communicated with the right ventricle by way of an opening low in the atrial septum and there was a large ventricular septal defect. The pulmonary trunk and aorta took their origin from the right and hypoplastic left ventricles respectively. The literature on this rare cardiac anomaly is reviewed and the morphological findings in this case are compared with those of the recorded cases. A short discussion of the possible embryogenesis is given.
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