Cusp degeneration in frame-supported autologous fascia lata mitral valves: Clinical results in 67 patients

Abstract

Sixty-seven metal-frame-supported autologous fascia lata mitral valves were placed in 67 patients. There was an operative mortality of 25% and an overall mortality of 40% within 20 months. Most of the late deaths were due to valve malfunction which occurred in 50% of survivors. Female patients demonstrated a much higher rate of valve dysfunction than did men. This malfunction of the fascial valves in the mitral position, which has not been observed in the aortic position, may be due to inappropriate design for the mitral position. The fascia is not exposed to the continued and reproducible mechanical stimulation in the atrioventricular position that it has when used as an aortic valve substitute. The mechanical properties of fascia may make it suitable for human valve substitutes but it is clear that an inverted three-cusped semilunar fascial valve will not be adequate for mitral or tricuspid valve replacements because of the haemodynamic characteristics of the atrioventricular position.

Natural history of fascia lata valves in the aortic and mitral positions

“…In the mitral position the pattern of valve failure is the same as that reported by McEnany, Ross, and Yates (1972), but in the aortic position satisfactory valve function to the time limit of the study was found to be the rule.…”

Ultrasonic Decalcification of Calcified Cardiac Valves and Annuli

“…No satisfactory substitute for cardiac valves yet exists; McGoon's (1971) choice was soon discredited (Welch et al, 1971;McEnany et al, 1972). Valvotomy, even for calcified mitral valves, gives longer survival than replacement (Gerami et al, 1971;Olinger et al, 1971).…”

A bioengenharia no Brasil, século XX: estado da arte

“…Esta válvula de difícil modelagem, geralmente feita logo antes de sua implantação, foi logo abandonada devido à rápida e acentuada retração fibroblástica de seus folhetos (Mc ENAMY et al, 1972, TRIBLE, 1972. A válvula de dura-mater homóloga, esterelizada e conservada em glicerol, foi proposta por Zerbini e Puig, em l971, e por eles utilizada para substituições mitrais e aórticas durante diversos anos (PUIG et al, 1975).…”