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(Circulation. 1968;38:664.)
© 1968 American Heart Association, Inc.

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Homograft Replacement of the Mitral Valve

RALPH E. GIANELLY M.D.¹; WILLIAM W. ANGELL M.D.¹; EDWARD STINSON M.D.¹; NORMAN E. SHUMWAY M.D.¹; DONALD C. HARRISON M.D.¹

¹ From the Cardiology Division, the Department of Medicine, and the Cardiovascular Surgery Division, the Department of Surgery, Stanford University School of Medicine, Palo Alto, California.

Replacement of the mitral valve with an aortic valve homograft has become feasible. Clinical and hemodynamic assessments of eight patients who received the new homograft were made from 3 to 6 months following surgery. Marked improvement was reported by six patients and mild to moderate improvement by two. At rest the homografts functioned well, creating a trivial diastolic gradient between the left atrium and left ventricle and being mildly insufficient in two cases. On exercise there was moderate mitral insufficiency. Anticoagulants were used for 3 months following surgery and then discontinued. In 60 subsequent patient-months no thromboembolism has been observed. The data are as yet inconclusive, but the homograft shows promise of being a reasonable alternative to the prostheses currently in use.

Key Words: Aortic valve homograft • Thromboembolism • Hemodynamic assessment • Anticoagulants